{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:03:16Z","timestamp":1791295396885,"version":"4.1.0"},"reference-count":3,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Therapeutic options for symptomatic non\u2010obstructive hypertrophic cardiomyopathy (nHCM) remain limited. We investigated whether right ventricular apical (RVA) pacing with optimal atrioventricular delay (AVD) can improve myocardial oxygen supply\u2013demand mismatch, assessed using coronary sinus (CS) lactate as a marker of microvascular ischemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients underwent atrial pacing at 70% of target heart rate followed by AV sequential pacing at individually optimized AVD. CS lactate levels were measured at baseline, during atrial pacing, after washout, and during AV sequential pacing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline CS lactate was 0.55\u2009\u00b1\u20090.15\u2009mmol\/L and increased to 1.13\u2009\u00b1\u20090.29\u2009mmol\/L during atrial pacing. After washout, levels returned to near baseline (0.59\u2009\u00b1\u20090.21\u2009mmol\/L). During AV sequential pacing at optimal AVD (142.8\u2009\u00b1\u200920.6\u2009ms), CS lactate decreased to 0.86\u2009\u00b1\u20090.31\u2009mmol\/L, showing a significant reduction compared to atrial pacing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). In 15 of 18 patients, CS lactate decreased during AV pacing compared with atrial pacing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AV sequential pacing at optimized AVD reduces CS lactate during exertion in most patients with nHCM, suggesting improved myocardial oxygen balance and reduced microvascular ischemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70432","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:37:10Z","timestamp":1785807430000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improvement of Microvascular Ischemia by Atrioventricular Sequential Pacing in Non\u2010Obstructive Hypertrophic Cardiomyopathy"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-2785","authenticated-orcid":false,"given":"Muthiah","family":"Subramanian","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9652-9918","authenticated-orcid":false,"given":"Radhika","family":"Manukonda","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6332-6129","authenticated-orcid":false,"given":"Sachin","family":"Yalagudri","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daljeet Kaur","family":"Saggu","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridevi","family":"Chennapragda","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7766-3473","authenticated-orcid":false,"given":"Calambur","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Department of Cardiology AIG Institute of Cardiac Sciences and Research  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.05.003"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.06.018"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.05.021"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70432","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/joa3.70432","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:45:16Z","timestamp":1791294316000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":3,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/joa3.70432"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70432","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-05-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70432"}}