{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:27:25Z","timestamp":1761060445820,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Mid-Atlantic Affiliate of the American Heart Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some patients with RBBB may respond to cardiac resynchronization therapy (CRT). However, little is known regarding the electromechanical substrate for CRT and whether this is the optimal pacing strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a pilot prospective double crossover randomized controlled clinical study comparing ventricular back up pacing (VVI\u201040), RV fusion pacing (DDD\u201040, RV only), and biventricular (BIV) pacing (DDD\u201040 BIV) in nine patients with RBBB and depressed EF. The study compared the frequency of dyssynchrony on baseline echocardiogram in patients with RBBB (n\u00a0=\u00a04), RBBB + anterior MI (RBBB with left axis deviation + left ventricular (LV) anterior wall thinning, n\u00a0=\u00a03), and RBBB + LAFB (RBBB with left axis deviation without LV anterior wall thinning n\u00a0=\u00a02). Echocardiographic assessment of LV dyssynchrony, LV size, and LV function was repeated after 6 months in each pacing mode.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with RBBB + LAFB demonstrated baseline echocardiographic dyssynchrony between the LV anterior and inferior wall. Both DDD\u201040 RV\u2010only pacing and DDD\u201040 BIV pacing resulted in improved LV function and clinical status compared to VVI\u201040 back up pacing. Patients with RBBB alone and RBBB with anterior MI had no baseline dyssynchrony and CRT using either RV only or BIV pacing resulted in LV dilation, worsened left ventricular ejection fraction and worsened clinical status compared to VVI\u201040 back up pacing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with RBBB, left axis deviation, and no prior anterior MI may have LV dyssynchrony between the anterior and inferior walls that is correctable with CRT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13231","type":"journal-article","created":{"date-parts":[[2017,10,31]],"date-time":"2017-10-31T12:22:35Z","timestamp":1509452555000},"page":"1358-1367","source":"Crossref","is-referenced-by-count":3,"title":["The electromechanical substrate for response to cardiac resynchronization therapy in patients with right bundle branch 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