{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T11:05:34Z","timestamp":1779534334545,"version":"3.53.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016304","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016304","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to determine optimal atrioventricular (AV) timing for left bundle branch area pacing (LBBAP) and optimal AV and interventricular (VV) timing for LBBAP optimized cardiac resynchronization therapy (LOT-CRT) to enhance the benefit of conduction system pacing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Acute measurements of LV dP\/dtmax and QRS duration were collected during sweeps of AV and VV delays during paired comparison of LBBAP, LOT-CRT, and biventricular pacing (BVP) in 48 CRT-indicated patients. Optimal AV delays were selected as the vertex of a parabolic model fit to the AV sweep results, obtained independently for LV dP\/dtmax and QRS duration. LBBAP, LOT-CRT, and BVP were similarly sensitive to the choice of AV delay, and 60 ms deviations from optimal AV delay resulted in an approximately 30% reduction in the haemodynamic benefits of resynchronization. Based upon LV dP\/dtmax measurements, the average optimal paced AV (PAV) for LBBAP (152 ms) was significantly shorter than that for LOT-CRT (171 ms, P &amp;lt; 0.01) or BVP (167 ms, P = 0.01). Based upon QRS duration, the average optimal PAV for LBBAP (164 ms) was similar to that for LOT-CRT (160 ms, P = 0.52) or BVP (165 ms, P = 0.95). For each resynchronization modality, a linear regression between the patient's measured intrinsic AV conduction and their optimal AV delay provided a patient-specific AV delay, resulting in improved AV selection compared to applying a fixed AV delay to all patients. Finally, simultaneous activation (VV = 0) was best for both LOT-CRT and BVP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LBBAP, LOT-CRT, and BVP are similarly sensitive to AV-timing. Optimal AV delay is linearly related to intrinsic AV for each resynchronization modality. For LOT-CRT and BVP, simultaneous biventricular activation is best on average.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration information<\/jats:title>\n                    <jats:p>https:\/\/clinicaltrials.gov\/study\/NCT04905290<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag103","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:24:55Z","timestamp":1777638295000},"source":"Crossref","is-referenced-by-count":0,"title":["Optimal pace timing for left bundle branch area pacing with or without an additional LV lead: results from the CSPOT study"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-7247","authenticated-orcid":false,"given":"Robert D","family":"Schaller","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology, Cardiovascular Division, Department of Medicine, Hospital 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Cardiology, University of Chicago, Pritzker School of Medicine , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0002-1955","authenticated-orcid":false,"given":"Rafa\u0142","family":"Gardas","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9772-0308","authenticated-orcid":false,"given":"Travis","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2869-8382","authenticated-orcid":false,"given":"D\u2019Anne","family":"Kudlik","sequence":"additional","affiliation":[{"name":"Medtronic , Mounds View, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W","family":"Stadler","sequence":"additional","affiliation":[{"name":"Medtronic , Mounds View, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-0385","authenticated-orcid":false,"given":"Patrick","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Medtronic , Mounds View, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1022-8998","authenticated-orcid":false,"given":"James","family":"Burrell","sequence":"additional","affiliation":[{"name":"Medtronic , Mounds View, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2790-2305","authenticated-orcid":false,"given":"Robert","family":"Waxman","sequence":"additional","affiliation":[{"name":"Medtronic , Mounds View, MN 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