{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:26:28Z","timestamp":1792787188989,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Right ventricular apical pacing (RVAP) can produce left ventricle dysfunction. Conduction system pacing (CSP) has been used successfully to reverse left ventricle dysfunction in patients with left bundle branch block. To date, data about CSP prevention of left ventricle dysfunction in patients with preserved left ventricular ejection fraction (LVEF) are scarce and limited mostly to nonrandomized studies. Our aim is to demonstrate that CSP can preserve normal ventricular function compared with RVAP in the setting of a high burden of ventricular pacing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Consecutive patients with a high-degree atrioventricular block and preserved or mildly deteriorated LVEF (&gt;40%) were included in this prospective, randomized, parallel, controlled study, comparing conventional RVAP versus CSP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Seventy-five patients were randomized, with no differences between basal characteristics in both groups. The stimulated QRS duration was significantly longer in the RVAP group compared with the CSP group (160.4\u00b118.1 versus 124.2\u00b120.2 ms;\n              <jats:italic toggle=\"yes\">p<\/jats:italic>\n              &lt;0.01). Seventy patients were included in the intention-to-treat analyses. LVEF showed a significant decrease in the RVAP group at 6 months compared with the CSP group (mean difference, \u22125.8% [95% CI, \u22129.6% to \u22122%];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.01). Left ventricular end-diastolic diameter showed an increase in the RVAP group compared with the CSP group (mean difference, 3.2 [95% CI, 0.1\u20136.2] mm;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04). Heart failure\u2013related admissions were higher in the RVAP group (22.6% versus 5.1%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Conduction system stimulation prevents LVEF deterioration and heart failure\u2013related admissions in patients with normal or mildly deteriorated LVEF requiring a high burden of ventricular pacing. These results are only short term and need to be confirmed by further larger studies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT06026683.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.012473","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T10:00:20Z","timestamp":1706522420000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Conduction System Stimulation to Avoid Left Ventricle Dysfunction"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct06026683","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-9279","authenticated-orcid":true,"given":"Carlos E.","family":"Gonz\u00e1lez-Matos","sequence":"first","affiliation":[{"name":"Electrophysiology Unit, Cardiology Department, Hospital del Mar, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Bellaterra, Spain (C.E.G.-M., E.V.)."},{"name":"Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Universitat Pompeu Fabra, Barcelona, Spain (C.E.G.-M., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2746-3243","authenticated-orcid":true,"given":"Oriol","family":"Rodr\u00edguez-Queralto","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiology Department, Hospital del Mar, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0706-1987","authenticated-orcid":true,"given":"F\u00e1tima","family":"Z\u00e1raket","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiology Department, Hospital del Mar, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiology Department, Hospital del Mar, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjam\u00edn","family":"Casteigt","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiology Department, Hospital del Mar, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., E.V.)."},{"name":"Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, Barcelona, Spain (C.E.G.-M., O.R.-Q., F.Z., J.J., B.C., 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