{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T07:52:47Z","timestamp":1773647567287,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/X502959\/1"],"award-info":[{"award-number":["MR\/X502959\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000833","name":"Rosetrees Trust","doi-asserted-by":"publisher","award":["IAA 2023\/1"],"award-info":[{"award-number":["IAA 2023\/1"]}],"id":[{"id":"10.13039\/501100000833","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/CRTF\/21\/24171"],"award-info":[{"award-number":["FS\/CRTF\/21\/24171"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left ventricular outflow obstruction drives symptoms and outcomes in obstructive hypertrophic cardiomyopathy (oHCM). Right ventricular pacing (RVP) can desynchronize the left ventricle to relieve this and allows control of atrioventricular delay (AVD) but may impair ventricular function. We used high\u2010precision assessment to quantify the hemodynamic and echocardiographic effects of RVP in oHCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with oHCM and implanted dual\u2010chamber pacing devices underwent continuous recording of ECG, beat\u2010by\u2010beat outflow tract continuous wave Doppler, and beat\u2010by\u2010beat, noninvasive finger\u2010cuff blood pressure while pacing was alternated between atrium\u2010only pacing and AV\u2010sequential RVP at a range of AVDs at 5\u00a0bpm above resting heart rate and 100\u00a0bpm. Changes in systolic blood pressure (\u2206SBP) and left ventricular outflow tract gradient (\u2206LVOTg) were fitted to parabolas to produce reproducible, narrow confidence interval estimates of effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty two patients were recruited (60% male, mean resting LVOTg 53\u00a0mmHg). At just above resting heart rate (mean 75\u00a0bpm), RVP produced mean peak \u2206SBP from AAI to DDD of 2.47\u00a0mmHg (95% confidence interval: 0.19\u20134.76,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04). The mean AVD for peak \u2206SBP was 173.2\u00a0ms. Mean LVOTg reduction at this AVD was 8.31\u00a0mmHg (2.43\u201314.18,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Apart from the hemodynamically optimum AVD, no other AVDs produced statistically significant increases in SBP. At 100\u00a0bpm, greater increases in SBP and reductions in LVOTg were seen at hemodynamically optimal AVD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple alternation assessment allows precise, reproducible, narrow confidence interval quantification of hemodynamic and echocardiographic pacing effects. RVP can reduce LVOTg while preserving or improving cardiac output, but AVD is a key modifier of this relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70024","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T10:58:37Z","timestamp":1755773917000},"page":"1138-1147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High\u2010Precision Hemodynamic and Echocardiographic Assessment of Pacing in Obstructive Hypertrophic Cardiomyopathy"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0442-4033","authenticated-orcid":false,"given":"Jagdeep S.","family":"Mohal","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Shun\u2010Shin","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla","family":"Chiew","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra A.","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florentina","family":"Simader","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pannathorn","family":"Tangkongpanich","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Bahl","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u2010Jian","family":"Chow","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Howard","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akriti","family":"Naraen","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keenan","family":"Saleh","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack W.","family":"Samways","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Keene","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. M. Afzal","family":"Sohaib","sequence":"additional","affiliation":[{"name":"Barts Heart Centre St Bartholomew's Hospital  West Smithfield London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Tanner","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London Hammersmith Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M. 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