{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:14:12Z","timestamp":1791670452176,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent studies suggested that the left bundle branch area pacing (LBBAP) has a better efficacy to reduce QRS duration and produce a lower pacing threshold than the conventional right ventricular outflow tract septal pacing (RVOP), which resulted in a better cardiac function and ventricular synchronization. However, whether the LBBAP has a better efficacy in improving left atrial structure, function in pace\u2010dependent patients compared with RVOP has not been well studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to compare the atrial outcomes of pace\u2010dependent patients who received LBBAP or RVOP procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A total of 72 patients (including II\u00b0 AVB, high AVB, and III\u00b0 AVB, excluding atrial fibrillation patients with atrioventricular block) consecutively enrolled in this single\u2010center prospective clinical study and randomly assigned to the RVOP group and the LBBP group with 36 patients. All patients were pace\u2010dependent. The changes in echocardiogram, speckle\u2010tracking echocardiography, brain natriuretic peptide (BNP), and 6\u2010min walking distance were documented and compared between two groups at baseline, 7 days, 1, 3, and 6 months after the implantation. There were no significant differences in baseline characteristics between the\u00a0two groups. The results of the study were as following: (1) left atrial structure index: Our study indicated that there are no significant differences in left atrial anteroposterior dimension (LAAPD), left atrial superoinferior dimension, and left atrial mediolateral dimension between two groups. While the LAAPD in the LBBAP group was significantly reduced at 6 months after implantation ([38.22\u2009\u00b1\u20092.17]\u2009mm vs. [34.13\u2009\u00b1\u20091.59]\u2009mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). (2) Left atrial strain index: We observed that the S% was significantly improved in both groups at 3 and 6 months after implantation but more prominent in the LBBAP group at 6 months (36.94\u2009\u00b1\u200911.67 vs. 25.87\u2009\u00b1\u20098.93, <jats:italic>p<\/jats:italic>\u2009=\u2009.01). SRs, SRe were improved in the RVOP group at 6 months after implantation but was further significantly increased in the LBBAP group. Similarly, the SRa in the LBBAP group was significantly better than the RVOP group after 6 months (\u22122.11\u2009\u00b1\u20090.75 vs. \u22122.51\u2009\u00b1\u20090.70, <jats:italic>p<\/jats:italic>\u2009=\u2009.04). (3) Left atrial ejection index: LAEF% in the LBBAP group was significantly improved compared with the RVOP group (60.02\u2009\u00b1\u20091.88 vs. 53.65\u2009\u00b1\u20092.45, <jats:italic>p<\/jats:italic>\u2009=\u2009.047) and baseline (60.02\u2009\u00b1\u20091.88 vs. 49.68\u2009\u00b1\u20092.75, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) at 6 months after the surgery. (4) Left ventricular ejection index: The LVEF% in the LBBAP group was significantly increased than the RVOP group after 6 months (69.14\u2009\u00b1\u20094.99 vs. 64.60\u2009\u00b1\u20094.84, <jats:italic>p<\/jats:italic>\u2009=\u2009.01) and the BNP level was significantly lower in the LBBAP group compared with the RVOP group at 7 days, 1, 3, and 6 months after implantation (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). (5) 6\u2010min walking distance: the 6\u2010min walking distance was significantly increased at 3 and 6 months after implantation compared with that before (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in both groups, but was more prominent in LBBAP groups ([483.03\u2009\u00b1\u200911.02]\u2009m vs. [431.09\u2009\u00b1\u200910.69]\u2009m,<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with the traditional RVOP, the LBBAP procedure increased left atrial myocardial stress as well as left atrial ejection in pace\u2010dependent patients at follow\u2010up to 6 months.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24185","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T03:28:57Z","timestamp":1700278137000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Left bundle branch area pacing improving the left atrial outcomes in pace\u2010dependent patients compared with right ventricular outflow tract septal pacing"],"prefix":"10.1002","volume":"47","author":[{"given":"Yanlei","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinglan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"You","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5596-8287","authenticated-orcid":false,"given":"Ruiqin","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Hospital of Hebei Medical University Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000072769.17295.B1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00586-4"},{"issue":"80","key":"e_1_2_9_4_1","first-page":"2303","article-title":"Pacing from the right ventricular septum and development of new atrial fibrillation in paced patients with atrioventricular block and preserved left ventricular function","volume":"11","author":"Hayashi K","year":"2016","journal-title":"J. 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