{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:47:00Z","timestamp":1783676820443,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/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>The benefits of cardiac resynchronization therapy (CRT) with biventricular pacing (BiV) is significantly lower when applied to heart failure (HF) patients with non\u2010left bundle branch block (LBBB) conduction delay. We investigated clinical outcomes of conduction system pacing (CSP) for CRT in non\u2010LBBB HF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive HF patients with non\u2010LBBB conduction delay undergoing CSP were propensity matched for age, sex, HF\u2010etiology, and atrial fibrillation (AF) in a 1:1 ratio to BiV from a prospective registry of CRT recipients. Echocardiographic response was defined as an increase in left ventricular ejection fraction (LVEF) by \u226510%. The primary outcome was the composite of HF\u2010hospitalizations or all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 96 patients were recruited (mean age 70\u2009\u00b1\u200911years, 22% female, 68% ischemic HF and 49% AF). Significant reductions in QRS duration and LV dimensions were seen only after CSP, while LVEF improved significantly in both groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Echocardiographic response occurred more frequently in CSP than BiV (51% vs. 21%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), with CSP independently associated with four\u2010fold increased odds (adjusted odds ratio 4.08, 95% confidence interval [CI] 1.34\u201312.41). The primary outcome occurred more frequently in BiV than CSP (69% vs. 27%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with CSP independently associated with 58% risk reduction (adjusted hazard ratio [AHR] 0.42, 95% CI 0.21\u20130.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), driven by reduced all\u2010cause mortality (AHR 0.22, 95% CI 0.07\u20130.68, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and a trend toward reduced HF\u2010hospitalization (AHR 0.51, 95% CI 0.21\u20131.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CSP provided greater electrical synchrony, reverse remodeling, improved cardiac function and survival compared to BiV in non\u2010LBBB, and may be the preferred CRT strategy for non\u2010LBBB HF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15881","type":"journal-article","created":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T07:10:10Z","timestamp":1678605010000},"page":"976-983","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Conduction system versus biventricular pacing in heart failure with non\u2010left bundle branch block"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-6883","authenticated-orcid":false,"given":"Eugene S. J.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Soh","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie\u2010Ying","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Boey","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ng Teng Fong General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhobeleen","family":"de Leon","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew Pang","family":"Chan","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee Tiong","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toon Wei","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swee\u2010Chong","family":"Seow","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6295-4905","authenticated-orcid":false,"given":"Pipin","family":"Kojodjojo","sequence":"additional","affiliation":[{"name":"Department of Cardiology National University Heart Centre Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University  Singapore Singapore"},{"name":"Department of Cardiology Ng Teng Fong General Hospital  Singapore 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