{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T07:59:35Z","timestamp":1758095975396,"version":"3.44.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left bundle branch block (LBBB) and right ventricular pacing (RVP) are associated with abnormal myocardial mechanics and cardiomyopathy. Consequently, chronic LBBB may increase the risk of heart failure and mortality in patients undergoing RVP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the TriNetX Analytics Network database, we identified patients who underwent pacemaker implantation between January 1, 2014 and January 1, 2024. Exclusion criteria included a history of heart failure, previous cardiac devices, cardiac resynchronization therapy (CRT) during the index hospitalization, or a left ventricular ejection fraction (LVEF) of less than 50%. The primary outcome incident systolic heart failure and all\u2010cause mortality occurring from the index hospitalization through November 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 70,526 patients undergoing RVP implantation, 3916 (5.6%) had chronic LBBB prior to the procedure, with a median age of 75\u00a0\u00b1\u00a015 years. Over a median follow\u2010up of 2.5 years, 5356 (7.6%) developed incident systolic heart failure, and 9714 (13.7%) experienced all\u2010cause mortality. After propensity score matching, chronic LBBB was associated with a higher risk of systolic heart failure (HR: 1.39; 95% CI: 1.20\u20131.62) but not all\u2010cause mortality (HR: 0.93; 95% CI: 0.83\u20131.06). Patients with chronic LBBB who developed systolic heart failure were more likely to present with moderately depressed LVEF and require CRT upgrades during follow\u2010up compared to those without chronic LBBB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chronic LBBB was associated with a higher risk of systolic heart failure, worse left ventricular function, and greater likelihood of CRT upgrade among patients undergoing RVP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.70020","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T10:15:26Z","timestamp":1754648126000},"page":"973-980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of Cardiomyopathy in Patients With Chronic Left Bundle Branch Block Undergoing Right Ventricular Pacing"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8371-2000","authenticated-orcid":false,"given":"Temidayo A.","family":"Abe","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3532-4171","authenticated-orcid":false,"given":"Favour","family":"Markson","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Jefferson Health\u2010Einstein Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Duke University School of Medicine Duke Clinical Research Institute  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"II","given":"Larry R.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Duke University School of Medicine Duke Clinical Research Institute  Durham North Carolina 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