{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:54:55Z","timestamp":1792425295303,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T00:00:00Z","timestamp":1516752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal timing for cardiac resynchronization therapy (CRT) after diagnosis of new\u2010onset left bundle branch block (LBBB)\u2010associated idiopathic nonischemic cardiomyopathy (NICM) and treatment with guideline\u2010directed medical therapy (GDMT) is unknown. The purpose of this study was to describe relationships between time from diagnosis to CRT and outcomes in new\u2010onset LBBB\u2010associated idiopathic NICM with left ventricular ejection fraction (LVEF) \u226435%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study examined associations between time from diagnosis to CRT (\u22649 months vs\u00a0&gt;9 months) and clinical and echocardiographic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 123 subjects with LBBB\u2010associated idiopathic NICM, time from diagnosis to CRT was \u22649 months in 60 (49%) subjects and\u00a09 months in 63 (51%) subjects. Clinical outcomes were similar for those implanted \u22649 months versus\u00a0&gt;9 months for adverse clinical events (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.41\u20131.78; P\u00a0=\u00a00.67) and all\u2010cause mortality (HR, 0.57; 95% CI, 0.19\u20131.70; P\u00a0=\u00a00.31). Multivariable analyses demonstrated similar results. In 105 subjects with post\u2010CRT echocardiograms, LVEF improvement to\u00a0&gt;35% was more likely in those implanted \u22649 months when compared to\u00a0&gt;9 months (odds ratio [OR], 3.53; 95% CI, 1.32\u20139.46; P\u00a0=\u00a00.01). This association persisted in the final multivariable model adjusted for age at diagnosis, sex, QRS duration, post\u2010GDMT LVEF, and time from CRT to post\u2010CRT echocardiogram (OR, 5.10; 95% CI, 1.71\u201315.22; P\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In LBBB\u2010associated idiopathic NICM, earlier CRT implantation was associated with more favorable cardiac remodeling. Delaying CRT may miss a critical period to halt and reverse progressive myocardial damage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13264","type":"journal-article","created":{"date-parts":[[2018,1,9]],"date-time":"2018-01-09T20:36:40Z","timestamp":1515530200000},"page":"143-154","source":"Crossref","is-referenced-by-count":43,"title":["New\u2010onset left bundle branch block\u2010associated idiopathic nonischemic cardiomyopathy and time from diagnosis to cardiac resynchronization therapy: The NEOLITH II study"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8388-2146","authenticated-orcid":false,"given":"Norman C.","family":"Wang","sequence":"first","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack Z.","family":"Li","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan C.","family":"Adelstein","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Althouse","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Sharbaugh","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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