{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:39:13Z","timestamp":1783226353035,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2022,9]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>It is unknown whether His\u2010Purkinje conduction system pacing (HPCSP), as either His bundle or left bundle branch pacing, could be an alternative to cardiac resynchronization therapy (BiVCRT) for patients with left ventricular dysfunction needing ventricular pacing due to atrioventricular block. The aim of the study is to compare the echocardiographic response and clinical improvement between HPCSP and BiVCRT.<\/jats:p><\/jats:sec>Methods<\/jats:title>Consecutive patients who successfully received HPCSP were compared with a historical cohort of BiVCRT patients. Patients were 1:1 matched by age, LVEF, atrial fibrillation, renal function and cardiomyopathy type. Responders were defined as patients who survived, did not require heart transplantation and increased LVEF \u22655 points at 6\u2010month follow\u2010up.<\/jats:p><\/jats:sec>Results<\/jats:title>HPCSP was successfully achieved in 92.5% (25\/27) of patients. During follow\u2010up, 8% (2\/25) of HPCSP patients died and 4% (1\/25) received a heart transplant, whereas 4% (1\/25) of those in the BiVCRT cohort died. LVEF improvement was 10% \u00b1 8% HPCSP versus 7% \u00b1 5% BiVCRT (p<\/jats:italic>\u00a0=\u00a0.24), and the percentage of responders was 76% (19\/25) HPCSP versus 64% (16\/25) BiVCRT (p<\/jats:italic>\u00a0=\u00a0.33). Among survivors, the percentage of patients who improved from baseline II\u2013IV mitral regurgitation (MR) to 0\u2013I MR was 9\/11 (82%) versus 2\/8 (25%) (p<\/jats:italic>\u00a0=\u00a0.02). Compared to those with BiVCRT, patients with HPCSP achieved better NYHA improvement: 1 point versus 0.5 (OR 0.34; p<\/jats:italic>\u00a0=\u00a0.02).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>HPCSP in patients with LVEF \u226445% and atrioventricular block improved the LVEF and induced a response similar to that of BiVCRT. HPCSP significantly improved MR and NYHA functional class. HPCSP may be an alternative to BiVCRT in these patients. (Figure\u00a01<\/jats:ext-link>. Central Illustration).<\/jats:p>Central illustration. Two therapeutic approaches in patients with ventricular dysfunction (LVEF\u00a0\u2264\u00a045%) and indication for pacing due to AV block: His Purkinje conduction system pacing (A) and biventricular CRT (B). HPCSP with either HBP or LBBP in patients with LVEF \u226445% dysfunction and a ventricular pacing indication showed an echocardiographic response at the 6\u2010month follow\u2010up comparable to that of biventricular CRT. Abbreviations: CRT, cardiac resynchronization therapy; HBP, His bundle pacing; LBBP, left bundle branch pacing [Colour figure can be viewed at wileyonlinelibrary.com<\/jats:ext-link>]<\/jats:p><\/jats:caption>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:sec>","DOI":"10.1111\/pace.14535","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T12:44:13Z","timestamp":1652877853000},"page":"1115-1123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Conduction system pacing vs. biventricular pacing in patients with ventricular dysfunction and AV block"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4523-6469","authenticated-orcid":false,"given":"Margarida","family":"Pujol\u2010L\u00f3pez","sequence":"first","affiliation":[{"name":"Institut Cl\u00ednic Cardiovascular (ICCV), Hospital Cl\u00ednic Universitat de Barcelona Catalonia 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