{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:01:13Z","timestamp":1785423673651,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Left bundle branch area pacing (LBBAP) has emerged as a physiologic alternative to conventional right ventricular and biventricular pacing, yet large real\u2010world evidence remains limited. We aimed to assess changes in ventricular function and symptoms after LBBAP in patients with different clinical indications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>Consecutive patients discharged with confirmed LBBAP across 29 Italian centers underwent evaluation of echocardiographic parameters and New York Heart Association (NYHA) functional class at follow\u2010up.<\/jats:p>\n                    <jats:p>\n                      A total of 697 patients were included: 532 with a bradycardia indication and 165 with a heart failure (HF) indication, assessed at a median follow\u2010up of 12.4 months. In the bradycardia group, left ventricular ejection fraction (LVEF) showed a slight improvement from 55% (interquartile range, 50\u201360) to 56% (52\u201360) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Paced\u2010induced cardiomyopathy (PICM), defined as a\u2009\u2265\u200910% absolute LVEF reduction to &lt;\u200950%, occurred in 3% of patients. Loss of LBBAP capture (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025) and lower LBBAP percentage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) were independent predictors of PICM.\n                    <\/jats:p>\n                    <jats:p>\n                      In the HF group, LVEF improved from 35% (30\u201341) to 45% (36\u201352) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Overall, 61.8% were classified as responders (LVEF increase \u2265\u20095%), rising to 73.8% among patients with \u2265\u200912 months of follow\u2010up. Higher LBBAP pacing percentage and absence of coronary artery disease independently predicted response. NYHA functional class improved significantly in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large real\u2010world cohort, LBBAP was associated with meaningful improvements in ventricular function and symptoms in both bradycardia and HF populations. A high percentage of effective LBBAP capture is essential for optimizing outcomes, supporting its role as an effective physiologic pacing strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70355","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:14:36Z","timestamp":1778177676000},"page":"1432-1441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Left Bundle Branch Area Pacing on Echocardiographic Parameters and Symptoms: Data From the Conduction System Pacing Italian Network Group (C\u2010SING) Study"],"prefix":"10.1111","volume":"37","author":[{"given":"Gabriele","family":"Dell'Era","sequence":"first","affiliation":[{"name":"Dipartimento Toraco\u2010Cardio\u2010Vascolare Clinica Cardiologica Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Cardiology Unit \u2018Card. 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Panico\u2019 Hospital Tricase Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Dugo","sequence":"additional","affiliation":[{"name":"AOU Policlinico G.Rodolico \u2010 San Marco Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1640-9428","authenticated-orcid":false,"given":"Francesco Raffaele","family":"Spera","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero \u2010 Universitaria Sant'Andrea Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2415-3821","authenticated-orcid":false,"given":"Alessandro","family":"Paoletti Perini","sequence":"additional","affiliation":[{"name":"Cardiology and Electrophysiology Unit, Department of Medical Specialties Azienda USL Toscana Centro, Santa Maria Nuova Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Mirizzi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana \u201cGabriele Monasterio\u201d Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Poggio","sequence":"additional","affiliation":[{"name":"Ospedale Maggiore Di Lodi Lodi Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca De","family":"Mattia","sequence":"additional","affiliation":[{"name":"Cardiology Department \u201cCa\u2019 Foncello\u201d Hospital Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-4372","authenticated-orcid":false,"given":"Amato","family":"Santoro","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Universitaria Senese Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Magnano","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale Sant'Andrea Vercelli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3948-4914","authenticated-orcid":false,"given":"Matteo","family":"Baroni","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, De Gasperis Cardio Center Niguarda Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Solimene","sequence":"additional","affiliation":[{"name":"Montevergine Clinic  Mercogliano (AV) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Castagno","sequence":"additional","affiliation":[{"name":"Division of Cariology, Department of Medical Sciences University of Turin \u2010 Citta\u0300 della Salute e della Scienza di Torino \u2013 Molinette Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiothoracic and vascular Department Pio XI Hospital Desio Monza and Brianza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Tomasi","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Universitaria Integrata Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rapacciuolo","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate\u2010Universita\u0300 degli Studi di Napoli Federico II Naples Italy"},{"name":"Ospedale Evangelico Betania Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Giudice","sequence":"additional","affiliation":[{"name":"Ospedale Umberto Parini Aosta Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Rovaris","sequence":"additional","affiliation":[{"name":"Cardiology Unit Fondazione IRCCS San Gerardo dei Tintori Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Coppolino","sequence":"additional","affiliation":[{"name":"SS Annunziata Hospital Savigliano Cuneo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzo Venanzio","family":"Iulianella","sequence":"additional","affiliation":[{"name":"Ospedale Sandro Pertini Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Giordano","sequence":"additional","affiliation":[{"name":"Presidio Ospedaliero \u201cSan Luca\u201d di Vallo della Lucania Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Tordini","sequence":"additional","affiliation":[{"name":"Clinical and Interventional Arrhythmology, S. 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