{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:14:08Z","timestamp":1779106448274,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"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":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Right ventricular (RV) apical pacing is associated with pacing induced cardiomyopathy. RV septal pacing has been proposed as a more physiological alternative, yet prior studies have yielded conflicting results. Cardiac computed tomography (CT) provides superior anatomical adjudication of lead position. We sought to evaluate whether CT\u2010confirmed septal lead placement is associated with improved clinical outcomes compared with non\u2010septal pacing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 657 patients who underwent PPM implantation at the University of Pittsburgh Medical Center with subsequent chest CT imaging. The lead position was adjudicated as septal or non\u2010septal. The primary outcome was a composite of heart failure hospitalization, atrial fibrillation admission, and\/or all\u2010cause mortality. Secondary outcomes included longitudinal changes in left ventricular ejection fraction (LVEF), and 12\u2010month admission burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 657 patients were analyzed. Mean age was 73.9\u2009\u00b1\u200911.9 years, 50.5% were female, and mean baseline LVEF was 54.9\u2009\u00b1\u20097.1%. 150 had septal leads (22.8%), and 507 (77.2%) had non\u2010septal leads. Over a median follow\u2010up of 5.3 years (IQR 3.1\u20138.2), the composite endpoint occurred in 70.2% of patients, with incidence in the septal group (62.7%) and non\u2010septal (72.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.21). In multivariable\u2010adjusted multivariable adjusted models, septal versus non\u2010septal pacing was not significantly associated with the composite outcome (HR\u2009=\u20091.00, 95% CI: 0.80\u20131.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.996). LVEF declined in the non\u2010septal group (54.0\u2009\u00b1\u20099.2% to 50.5\u2009\u00b1\u200911.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but remained stable in the septal group (55.0\u2009\u00b1\u20096.6% to 54.9\u2009\u00b1\u20097.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.43). No significant differences were observed in the 12\u2010month admission rates by lead position.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Septal pacing was associated with preservation of left ventricular function compared to non\u2010septal pacing, although this advantage did not translate to improved clinical outcomes. Septal pacing may help to reduce pacing\u2010induced ventricular dysfunction when conduction system pacing is not feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70307","type":"journal-article","created":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T13:30:03Z","timestamp":1773581403000},"page":"936-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Septal Versus Non\u2010Septal Right Ventricular Pacemaker Leads as Adjudicated by CT Imaging"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2039-9846","authenticated-orcid":false,"given":"Emma C.","family":"Osterhaus","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Kumar","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio S.","family":"Bittencourt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya","family":"Bhonsale","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark N. A.","family":"Estes","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna","family":"Kancharla","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir F.","family":"Saba","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Voigt","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-7678","authenticated-orcid":false,"given":"Alaa A.","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7189-8434","authenticated-orcid":false,"given":"Konstantinos N.","family":"Aronis","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"},{"name":"Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital Johns Hopkins School 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