{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T04:02:43Z","timestamp":1749960163354,"version":"3.41.0"},"reference-count":7,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"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":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Right ventricular apex (RVA) pacing has been reported to induce pacing\u2010induced cardiomyopathy (PICM), with biventricular pacing being the standard cardiac resynchronization therapy (CRT) for RVA\u2010PICM. However, recent studies suggest that left bundle branch area pacing (LBBAP) may provide even better outcomes as a CRT. In this case, we observed a dynamic alteration in the left ventricular (LV) activation pattern when transitioning from RVA\u2010PICM to LBBAP, including changes in the functional block line.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>A female patient with dilated\u2010phase hypertrophic cardiomyopathy (d\u2010HCM), septal, and apical myocardial damage caused by cardiomyopathy, and prior ventricular tachycardia ablations experienced worsening heart failure due to dyssynchronous LV activation from RVA pacing (paced QRS duration of 250\u00a0ms). She underwent an upgrade to LBBAP (paced QRS duration of 160\u00a0ms) as CRT. Six months later, three\u2010dimensional LV activation mapping was performed during both RVA pacing and LBBAP. During RVA pacing, a functional conduction block was observed in the anterior wall, resulting in unidirectional excitation propagation in a counterclockwise direction from the septum and a significant delay in the basal\u2010mid anterior wall. In contrast, with LBBAP, the functional conduction block shifted to the septal\u2010apical region, enabling bidirectional excitation propagation to the basal\u2010mid lateral wall and facilitating synchronized excitation in vertically opposing LV segments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The change in LV activation is specific to this d\u2010HCM case with damaged septum and apex; however, it provides one of the insights into the mechanisms by which LBBAP exerts its beneficial effects when upgrading from RVA\u2010PICM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15195","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T08:33:57Z","timestamp":1746520437000},"page":"640-643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Bundle Branch Area Pacing Corrected the Functional Block Line Caused by Right Ventricular Apex Pacing"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0089-9779","authenticated-orcid":false,"given":"Kentaro","family":"Goto","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Negishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwanari","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Yamao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masateru","family":"Takigawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2022.09.019"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.05.006"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.04.015"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.02.024"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad043"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118502.91105.F6"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.02.021"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.15195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T10:54:42Z","timestamp":1749898482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.15195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/pace.15195"],"URL":"https:\/\/doi.org\/10.1111\/pace.15195","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"type":"print","value":"0147-8389"},{"type":"electronic","value":"1540-8159"}],"subject":[],"published":{"date-parts":[[2025,5,6]]},"assertion":[{"value":"2025-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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