{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:48:36Z","timestamp":1790293716291,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"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":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe first\u2010degree atrioventricular (AV) block may produce symptoms similar to heart failure due to AV dyssynchrony, a syndrome termed AV dromotropathy. According to guidelines, it should be considered for permanent pacemaker implantation, yet evidence supporting this treatment is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to determine the impact of AV\u2010optimized conduction system pacing (CSP) in patients with symptomatic severe first\u2010degree AV block and echocardiographic signs of AV dyssynchrony.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with symptomatic first\u2010degree AV block (PR\u2009&gt;\u2009250\u2009ms), preserved left ventricular ejection fraction, narrow QRS, and AV dyssynchrony were included in the study. In a single\u2010blind cross\u2010over design, patients were randomized to AV sequential CSP or backup VVI pacing with a base rate of 40\u2009bpm. We compared exercise capacity, echocardiographic parameters, and symptom occurrence at the end of 3 months of each period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen patients completed the study. During the AV\u2010optimized CSP compared to the backup pacing period, patients achieved a higher workload on exercise test (147.2\u2009\u00b1\u200950.9 vs. 140.7\u2009\u00b1\u200955.8\u2009W; <jats:italic>p<\/jats:italic>\u2009=\u2009.032), with a trend towards higher peak VO2 (23.3\u2009\u00b1\u20097.1 vs. 22.8\u2009\u00b1\u20097.1\u2009mL\/min\/kg; <jats:italic>p<\/jats:italic>\u2009=\u2009.224), and higher left ventricular stroke volume (LVSV 74.5\u2009\u00b1\u200913.8 vs. 66.4\u2009\u00b1\u200912.5\u2009mL; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Symptomatic improvement was recorded, with fewer patients reporting general tiredness and 71% of patients preferring the AV\u2010optimized CSP (<jats:italic>p<\/jats:italic>\u2009=\u2009.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AV\u2010optimized CSP could improve symptoms, exercise capacity and LVSV in patients with severe first\u2010degree AV block.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16268","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T09:18:27Z","timestamp":1714468707000},"page":"1340-1350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["AV\u2010optimized conduction system pacing for treatment of AV dromotropathy: A randomized, cross\u2010over study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3650-5986","authenticated-orcid":false,"given":"Anja","family":"Zupan Me\u017enar","sequence":"first","affiliation":[{"name":"Department of Cardiology University Medical Center Ljubljana Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6258-6401","authenticated-orcid":false,"given":"Miha","family":"Mrak","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ziekenhuis Oost\u2010Limburg Genk Belgium"},{"name":"Faculty of Medicine and Life Sciences University Hasselt Hasselt Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jernej","family":"\u0160tublar","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Ljubljana Ljubljana Slovenia"},{"name":"Department of Cardiovascular Surgery University Medical Center Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Ivanovski","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-3989","authenticated-orcid":false,"given":"David","family":"\u017di\u017eek","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Ljubljana Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana Ljubljana 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