{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T03:01:10Z","timestamp":1771556470979,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"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":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Fusion pacing requires correct timing of left ventricular pacing to right ventricular activation, although it is unclear whether this is maintained when atrioventricular (AV) conduction changes during exercise. We used cardiopulmonary exercise testing (CPET) to compare cardiac resynchronization therapy (CRT) using fusion pacing or fixed AV delays (AVD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients 6 months post\u2010CRT implant with PR intervals\u2009&lt;\u2009250\u2009ms performed two CPET tests, using either the SyncAV\u2122 algorithm or fixed AVD of 120\u2009ms in a double\u2010blinded, randomized, crossover study. All other programming was optimized to produce the narrowest QRS duration (QRSd) possible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients (11 male, age 71 [65\u201377] years) were recruited. Fixed AVD and fusion programming resulted in similar narrowing of QRSd from intrinsic rhythm at rest (<jats:italic>p<\/jats:italic>\u2009=\u2009.85). Overall, there was no difference in peak oxygen consumption (V\u0307O<jats:sub>2<\/jats:sub><jats:sup>PEAK<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u2009.19), oxygen consumption at anaerobic threshold (VT1, <jats:italic>p<\/jats:italic>\u2009=\u2009.42), or in the time to reach either V\u0307O<jats:sub>2<\/jats:sub><jats:sup>PEAK<\/jats:sup> (<jats:italic>p<\/jats:italic>\u2009=\u2009.81) or VT1 (<jats:italic>p<\/jats:italic>\u2009=\u2009.39). The BORG rating of perceived exertion was similar between groups. CPET performance was also analyzed comparing whichever programming gave the narrowest QRSd at rest (119 [96\u2013136] vs. 134 [119\u2013142]\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). QRSd during exercise (<jats:italic>p<\/jats:italic>\u2009=\u2009.03), peak O<jats:sub>2<\/jats:sub> pulse (mL\/beat, a surrogate of stroke volume, <jats:italic>p<\/jats:italic>\u2009=\u2009.03), and cardiac efficiency (watts\/mL\/kg\/min, <jats:italic>p<\/jats:italic>\u2009=\u2009.04) were significantly improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fusion pacing is maintained during exercise without impairing exercise capacity compared with fixed AVD. However, using whichever algorithm gives the narrowest QRSd at rest is associated with a narrower QRSd during exercise, higher peak stroke volume, and improved cardiac efficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16120","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T10:43:34Z","timestamp":1698403414000},"page":"146-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cardiac resynchronization using fusion pacing during exercise"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-6479","authenticated-orcid":false,"given":"Peregrine G.","family":"Green","sequence":"first","affiliation":[{"name":"Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre University of Oxford Oxford UK"},{"name":"Department of Cardiovascular Medicine, Radcliffe Department of Medicine University of Oxford Oxford 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Centre John Radcliffe Hospital, University of Oxford NHS Foundation Trust Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Herring","sequence":"additional","affiliation":[{"name":"Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre University of Oxford Oxford UK"},{"name":"Oxford Heart Centre John Radcliffe Hospital, University of Oxford NHS Foundation Trust Oxford 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