{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:36:04Z","timestamp":1793144164957,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Imperial College London Biomedical Research Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Left bundle branch pacing (LBBP) can deliver physiological left ventricular activation, but typically at the cost of delayed right ventricular (RV) activation. Right ventricular activation can be advanced through anodal capture, but there is uncertainty regarding the mechanism by which this is achieved, and it is not known whether this produces haemodynamic benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We recruited patients with LBBP leads in whom anodal capture eliminated the terminal R-wave in lead V1. Ventricular activation pattern, timing, and high-precision acute haemodynamic response were studied during LBBP with and without anodal capture. We recruited 21 patients with a mean age of 67 years, of whom 14 were males. We measured electrocardiogram timings and haemodynamics in all patients, and in 16, we also performed non-invasive mapping. Ventricular epicardial propagation maps demonstrated that RV septal myocardial capture, rather than right bundle capture, was the mechanism for earlier RV activation. With anodal capture, QRS duration and total ventricular activation times were shorter (116 \u00b1 12 vs. 129 \u00b1 14\u2005ms, P &amp;lt; 0.01 and 83 \u00b1 18 vs. 90 \u00b1 15\u2005ms, P = 0.01). This required higher outputs (3.6 \u00b1 1.9 vs. 0.6 \u00b1 0.2\u2005V, P &amp;lt; 0.01) but without additional haemodynamic benefit (mean difference \u22120.2 \u00b1 3.8\u2005mmHg compared with pacing without anodal capture, P = 0.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Left bundle branch pacing with anodal capture advances RV activation by stimulating the RV septal myocardium. However, this requires higher outputs and does not improve acute haemodynamics. Aiming for anodal capture may therefore not be necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euad264","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T16:18:14Z","timestamp":1695658694000},"source":"Crossref","is-referenced-by-count":26,"title":["Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute haemodynamics"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3169-4776","authenticated-orcid":false,"given":"Nadine","family":"Ali","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7462-8103","authenticated-orcid":false,"given":"Khulat","family":"Saqi","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7597-0170","authenticated-orcid":false,"given":"Ahran D","family":"Arnold","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1958-7027","authenticated-orcid":false,"given":"Alejandra 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Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Little","sequence":"additional","affiliation":[{"name":"Medtronic Limited , Watford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-8078","authenticated-orcid":false,"given":"Nicholas S","family":"Peters","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-2185","authenticated-orcid":false,"given":"Prapa","family":"Kanagaratnam","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , 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F","family":"Linton","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-8292","authenticated-orcid":false,"given":"David C","family":"Lefroy","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3410-0814","authenticated-orcid":false,"given":"Darrel P","family":"Francis","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute\u2014Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du 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