{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:52:43Z","timestamp":1773031963274,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ventricular pacing at a shorter cycle length to premature ventricular contractions (PVCs), termed either as ventricular rate regularisation (VRR) or rate smoothing can be used to increase the percentage of biventircualr pacing and to avoid the long\u2010short\u2010long sequence caused by PVCs causing ventricular tachycardias (VTs). However, the risk of inappropriate rate increase by VRR during frequent PVCs in worsening heart failure in patients with CRT\u2010D has not been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>A 72\u2010year\u2010old man with dilated cardiomyopathy and atrial fibrillation received a CRT\u2010D after atrioventricular nodal ablation. He presented with heart failure and a persistent biventricular (BV) pacing rate of over 100\u2009bpm. Frequent PVCs and non\u2010sustained VT increased and sustained the pacing rate through VRR. Rate amelioration was partially achieved with antiarrhythmic medications and normalised by inactivation of VRR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with CRT\u2010D and frequent PVCs, VRR should be considered as a cause for inappropriate pacing rate that could worsen heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70106","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T04:15:55Z","timestamp":1758168955000},"page":"2643-2647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Effect of Ventricular Rate Regularization Pacing in Biventricular Cardiac Resynchronization Therapy"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3526-8950","authenticated-orcid":false,"given":"Chu\u2010Pak","family":"Lau","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy Lai\u2010Fun","family":"Lee","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung\u2010Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital The University of Hong Kong Hong Kong SAR China"},{"name":"Cardiac and Vascular Center the University off Hong Kong Shenzhen Hospital Shenzhen China"},{"name":"Centre for Stem Cell Translational Biology Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1998.tb00096.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.06.034"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup087"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.026"},{"key":"e_1_2_6_6_1","unstructured":"Boston Corporation menu on Ventricular Rate Regularization https:\/\/www.bostonscientific.com\/content\/dam\/elabeling\/crm\/pr\/360201-001_Tachy_CRT-D_RG_en-GBR_W_S.pdf. P.4 \u2013 49."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1027407829958"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.01.021"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14276"},{"key":"e_1_2_6_10_1","unstructured":"Medtronic Adapta\u2122\/Versa\u2122\/Sensia\u2122 Reference Guide.; Medtronic Consulta\u2122 CRT\u2010P Clinician Manual;Medtronic Protecta\u2122 XT DR Clinician Manual; Medtronic Protecta\u2122 XT CRT\u2010D Clinician Manual https:\/\/www.medtronicacademy.com\/features\/ventricular-rate-stabilization-vrs-feature."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.01708.x"},{"key":"e_1_2_6_12_1","first-page":"1688","article-title":"Heart Failure\u2010Related Hospitalization After the Implementation of a Ventricular Rate Modulation Algorithm","volume":"5","author":"Arnaldo F. 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