{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:51:18Z","timestamp":1785909078806,"version":"3.56.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The electromechanical window (EMW), defined as the difference between mechanical and electrical systole, is an emerging marker of arrhythmic risk and ventricular dysfunction. Although cardiac resynchronization therapy (CRT) improves mechanical synchrony, the influence of different pacing strategies on EMW is not well established. This study compared the effects of conventional biventricular (BiV) pacing and left bundle branch area pacing (LBBAP) on EMW, reverse remodeling, CRT response, and arrhythmic burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, observational study, 80 patients with left ventricular ejection fraction (LVEF)\u2009\u2264\u200935% undergoing CRT received BiV pacing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940) or LBBAP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940). Echocardiography with simultaneous electrocardiography was performed at baseline and 6 months. The primary endpoint was change in EMW.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 6 months, LBBAP was associated with greater QRS narrowing (42\u2009\u00b1\u200915 vs. 28\u2009\u00b1\u200913 ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and EMW normalization (\u2212\u200938\u2009\u00b1\u200922 to \u2212\u20095\u2009\u00b1\u200918 ms vs.\u2009\u2212\u200936\u2009\u00b1\u200920 to \u2212\u200918\u2009\u00b1\u200919 ms;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Improvements in LVEF, global longitudinal strain, and left ventricular end-systolic volume were also greater with LBBAP. EMW improvement correlated with reverse remodeling and QRS narrowing. Baseline EMW predicted CRT response (AUC 0.71), while persistent EMW negativity was associated with a higher incidence of non-sustained ventricular tachycardia (45% vs. 18%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LBBAP was associated with greater EMW normalization, improved reverse remodeling, and a lower arrhythmic burden than BiV pacing. EMW may represent an integrative marker of CRT response and residual arrhythmic risk. These findings are hypothesis-generating and require validation in larger multicenter randomized studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s43044-026-00772-1","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:32:56Z","timestamp":1785907976000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Electromechanical window as an integrative marker of remodeling and arrhythmic risk in biventricular vs. left bundle branch area pacing"],"prefix":"10.1186","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4684-7410","authenticated-orcid":false,"given":"Arvind","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salil","family":"Jaura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"issue":"36","key":"772_CR1","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, B\u00f6hm M, ESC Scientific Document Group et al (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. 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Written informed consent was taken for each participant.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work the author(s) used ChatGPT in order to paraphrase few sentences. After using this tool\/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.","order":2,"name":"Ethics","label":"Declarations of generative AI and AI-assisted technologies in the manuscript preparation process","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"61"}}