{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:20:28Z","timestamp":1790727628874,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the predictors of pacing\u2010induced cardiomyopathy (PICM) and illustrate the safety and feasibility of conduction system pacing (CSP) upgrade on patients with long\u2010term persistent atrial fibrillation (AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with long\u2010term persistent AF and normal left ventricular ejection fraction (LVEF) \u226550% were consecutively enrolled from January 2008 to December 2017, and all the patients with atrioventricular block (AVB) and high right ventricular pacing (RVP) percentage of at least 40%. The predictors of PICM were identified, and patients with PICM were followed up for at least 1 year regardless of CSP upgrade. Cardiac performances and lead outcomes were investigated in all patients before and after CSP upgrade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The present study included 139 patients, out of which 37 (26.62%) developed PICM, resulting in a significant decrease in the left ventricular ejection fraction (LVEF) from 56.11\u00a0\u00b1\u00a02.56% to 38.10\u00a0\u00b1\u00a05.81% (<jats:italic>p<\/jats:italic>&lt;\u00a0.01). The median duration for the development of PICM was 5.43 years. Lower LVEF (\u226452.50%), longer paced QRS duration (\u2265175\u00a0ms), and higher RVP percentage (\u226596.80%) were identified as independent predictors of PICM. Furthermore, the morbidity of PICM progressively increased with an increased number of predictors. The paced QRS duration (183.90\u00a0\u00b1\u00a022.34\u00a0ms vs. 136.57\u00a0\u00b1\u00a020.71\u00a0ms, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01), LVEF (39.35\u00a0\u00b1\u00a02.71%\u00a0vs. 47.50\u00a0\u00b1\u00a07.43%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01), and left ventricular end\u2010diastolic diameter (LVEDD) (55.53\u00a0\u00b1\u00a05.67\u00a0mm vs. 53.20\u00a0\u00b1\u00a05.78\u00a0mm, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03) improved significantly on patients accepting CSP upgrade. CSP responses and complete reverse remodeling (LVEF \u226550% and LVEDD\u00a0&lt;\u00a050\u00a0mm) were detected in 80.95% (17\/21) and 42.9% (9\/21) of patients. The pacing threshold (1.52\u00a0\u00b1\u00a00.78\u00a0V\/0.4\u00a0ms vs. 1.27\u00a0\u00b1\u00a00.59\u00a0V\/0.4\u00a0ms, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.16) was stable after follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PICM is very common in patients with long\u2010term persistent AF, and CSP upgrade was favorable for better cardiac performance in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14752","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T13:38:13Z","timestamp":1687613893000},"page":"684-692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of pacing\u2010induced cardiomyopathy detection and outcomes demonstration after conduction system pacing upgrade on patients with long\u2010term persistent atrial fibrillation"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4905-415X","authenticated-orcid":false,"given":"Nan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3579-8000","authenticated-orcid":false,"given":"Pei\u2010pei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao\u2010meng","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010jing","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu\u2010lu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010ni","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian\u2010jie","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo\u2010cao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010heng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010ming","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated 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