{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:26:39Z","timestamp":1783567599677,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Conduction system pacing (CSP), in the form of His bundle pacing (HBP) or left bundle branch pacing (LBBP), is emerging as a valuable cardiac resynchronization therapy (CRT) delivery method. However, patient selection and therapy personalization for CSP delivery remain poorly characterized. We aim to compare pacing\u2010induced electrical synchrony during CRT, HBP, LBBP, HBP with left ventricular (LV) epicardial lead (His\u2010optimized\u00a0CRT [HOT\u2010CRT]), and LBBP with LV epicardial lead (LBBP\u2010optimized CRT [LOT\u2010CRT]) in patients with different conduction disease presentations using computational modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We simulated ventricular activation on 24\u00a0four\u2010chamber heart geometries, including His\u2013Purkinje systems with proximal left bundle branch block (LBBB). We simulated septal scar, LV lateral wall scar, and mild and severe myocardium and LV His\u2013Purkinje system conduction disease by decreasing the conduction velocity (CV) down to 70% and 35% of the healthy CV. Electrical synchrony was measured by the shortest interval to activate 90% of the ventricles (90% of biventricular activation time [BIVAT\u201090]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severe LV His\u2013Purkinje conduction disease favored CRT (BIVAT\u201090: HBP 101.5\u2009\u00b1\u20097.8\u2009ms vs.\u00a0CRT 93.0\u2009\u00b1\u20098.9\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), with additional electrical synchrony induced by HOT\u2010CRT (87.6\u2009\u00b1\u20096.7\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) and LOT\u2010CRT (73.9\u2009\u00b1\u20097.6\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Patients with slow myocardium CV benefit more from CSP compared to CRT (BIVAT\u201090: CRT 134.5\u2009\u00b1\u200924.1\u2009ms; HBP 97.1\u2009\u00b1\u20099.9\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01; LBBP: 101.5\u2009\u00b1\u200910.7\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Septal but not lateral wall scar made CSP ineffective, while CRT was able to resynchronize the ventricles in the presence of septal scar (BIVAT\u201090: baseline 119.1\u2009\u00b1\u200910.8\u2009ms vs.\u00a0CRT 85.1\u2009\u00b1\u200914.9\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Severe LV His\u2013Purkinje conduction disease attenuates the benefits of CSP, with additional improvements achieved with HOT\u2010CRT and LOT\u2010CRT. Septal but not lateral wall scars make CSP ineffective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15847","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T08:00:59Z","timestamp":1675497659000},"page":"984-993","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Effect of scar and His\u2013Purkinje and myocardium conduction on response to conduction system pacing"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1312-251X","authenticated-orcid":false,"given":"Marina","family":"Strocchi","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karli","family":"Gillette","sequence":"additional","affiliation":[{"name":"BioTechMed\u2010Graz Graz Austria"},{"name":"Gottfried Schatz Research Center Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurel","family":"Neic","sequence":"additional","affiliation":[{"name":"NumeriCor GmbH Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2805-3043","authenticated-orcid":false,"given":"Mark K.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering King's College London London UK"},{"name":"Guy's and St Thomas' NHS Foundation trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeev","family":"Wijesuriya","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering King's College London London UK"},{"name":"Guy's and St Thomas' NHS Foundation trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6140-068X","authenticated-orcid":false,"given":"Vishal","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering King's College London London UK"},{"name":"Guy's and St Thomas' NHS Foundation trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Vigmond","sequence":"additional","affiliation":[{"name":"CNRS University of Bordeaux Bordeaux Talence France"},{"name":"IHU Liryc Bordeaux Talence France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7380-6908","authenticated-orcid":false,"given":"Gernot","family":"Plank","sequence":"additional","affiliation":[{"name":"BioTechMed\u2010Graz Graz Austria"},{"name":"Gottfried Schatz Research Center Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering King's College London London UK"},{"name":"Guy's and St Thomas' NHS Foundation trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Niederer","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering King's College London London 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