{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:34:32Z","timestamp":1786714472968,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"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":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left bundle branch block (LBBB) is associated with heterogeneous electrical and structural remodeling; however, the interplay between myocardial fibrosis and conduction abnormalities remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate fibrosis distribution and electrical activation patterns in LBBB patients with preserved (LBBB idiopathic [LBBBi]) and reduced (15 cardiac resynchronization therapy [CRT] recipients) systolic function using noninvasive electrocardiographic activation mapping (NEAM) and late gadolinium enhancement cardiovascular magnetic resonance (LGE\u2010CMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Twenty LBBB patients (15 CRT, 5 LBBBi) and five healthy volunteers (HV) underwent NEAM and LGE\u2010CMR. Global and segmental activation times (epicardial\/endocardial ATs), fibrosis volume, and latest activation zone (LAZ) localization were analyzed. Segmental correlations between fibrosis and activation parameters were evaluated in the CRT group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CRT patients demonstrated longer total ATs than LBBBi (176\u2009\u00b1\u200918 vs. 148\u2009\u00b1\u200910\u2009ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). LAZ localized to segments 5\u20136 in 80% of cases, with displacement in three CRT patients with midwall fibrosis. Fibrosis (17.4 [7.3\u201353.7]\u2009cm\u00b3) was present in 86.7% of CRT patients but absent in LBBBi and HV. Global ATs showed no correlation with fibrosis volume (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.159,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.571), but segmental fibrosis volume moderately correlated with epicardial (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and endocardial (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.307,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) ATs. Most segments in both groups demonstrated prolonged epicardial conduction, while endocardial conduction remained near\u2010normal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrated NEAM\u2010LGE\u2010CMR analysis demonstrated that myocardial fibrosis modulates local conduction abnormalities without influencing global activation times. All LBBB patients exhibit prolonged epicardial activation time regardless of fibrosis burden, while endocardial activation time remains preserved in most left ventricular segments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70226","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T04:44:37Z","timestamp":1765946677000},"page":"347-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myocardial Fibrosis Distribution and Electrical Activation Patterns in Left Bundle Branch Block: Integration of Non\u2010Invasive Electrocardiographic Activation Mapping and Cardiovascular Magnetic Resonance Imaging Late Gadolinium Enhancement"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-5474","authenticated-orcid":false,"given":"Elena","family":"Rimskaya","sequence":"first","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Chmelevsky","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Center St Petersburg Russia"},{"name":"Saint Petersburg State University St Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Aparina","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Bazhutina","sequence":"additional","affiliation":[{"name":"Saint Petersburg State University St Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Budanova","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Center St Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svyatoslav","family":"Khamzin","sequence":"additional","affiliation":[{"name":"Saint Petersburg State University St Petersburg Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Kashtanova","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madina","family":"Utsumueva","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Gaman","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Stukalova","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Ternovoy","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Golitsyn","sequence":"additional","affiliation":[{"name":"Chazov National Medical Research Center of Cardiology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.960898"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/math8081352"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.05.054"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.1363"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038648"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.09.004"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.007175"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004419"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.11.010"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2024.107713"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.2089"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.4022\/jafib.2206"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.613414"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.22489\/CinC.2023.160"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc0402.102975"},{"key":"e_1_2_8_18_1","volume-title":"Designing and Conducting Survey Research: A Comprehensive Guide","author":"Rea L. M.","year":"2014"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae025"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-012-9351-1"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.03.012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.10.010"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14845"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118502.91105.F6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.613414"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1369\/0022155417730280"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.14670\/HH-11-591"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1679\/aohc.72.139"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euy035"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardiores.2005.03.008"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70226","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70226","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:56:57Z","timestamp":1786712217000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,16]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jce.70226"],"URL":"https:\/\/doi.org\/10.1111\/jce.70226","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,16]]},"assertion":[{"value":"2025-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}