{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:18:41Z","timestamp":1783423121597,"version":"3.54.6"},"reference-count":27,"publisher":"IMR Press","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82300500"],"award-info":[{"award-number":["82300500"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Individuals affected with bradyarrhythmia and hypertension exhibit distinct clinical manifestations. Arrhythmia is commonly managed with an artificial cardiac pacemaker. This study aims to investigate the effects of left bundle branch pacing (LBBP) and right ventricular septal pacing (RVSP) on blood pressure and cardiac function in patients with bradyarrhythmia and hypertension. Methods: This retrospective study included 1060 patients with bradyarrhythmia and hypertension who were treated in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between January 2020 and December 2023. According to the placement of cardiac pacing leads, patients were divided into the LBBP group (N = 260) and the RVSP group (N = 800). Baseline clinical characteristics were recorded, and intergroup comparisons were performed for postoperative blood pressure, cardiac function indicators, pacing parameters, QRS duration, and incidence of postoperative adverse events. Results: Postoperatively, the LBBP group demonstrated significantly lower systolic blood pressure (SBP) and pulse pressure (PP) compared to the RVSP group (both p &lt; 0.05). Regarding the time \u00d7 group interaction, the interaction was significant for PP and SBP (p &lt; 0.05). Significant time effects were observed for left ventricular ejection fraction (LVEF), cardiac output (CO), and cardiac index (CI) in both groups (all p &lt; 0.05), and the group effect was significant for CI (p &lt; 0.05). Regarding ventricular pacing percentage, both groups showed a significant decrease over time (p &lt; 0.05); the LBBP group exhibited a slightly lower percentage than the RVSP group (p &lt; 0.05), with a significant time \u00d7 group interaction (p &lt; 0.05). Similarly, threshold decreased over time (p &lt; 0.05), while perception and impedance remained stable (p &gt; 0.05). The paced QRS duration was significantly narrower with LBBP during the follow-up period (p &lt; 0.05). Additionally, no significant differences were observed in the incidence of adverse events between the two groups, indicating comparable safety profiles (p &gt; 0.05). Conclusion: In patients with bradyarrhythmia and hypertension, LBBP offers significant therapeutic benefits in reducing SBP, pulse pressure, and QRS duration, while maintaining safety profiles and stable pacing parameters.<\/jats:p>","DOI":"10.31083\/bjhm54928","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:55:28Z","timestamp":1783421728000},"source":"Crossref","is-referenced-by-count":0,"title":["Effects of Left Bundle Branch Pacing and Right Ventricular Pacing on Blood Pressure and Cardiac Function in Patients With Bradyarrhythmia Complicated With Hypertension"],"prefix":"10.31083","volume":"87","author":[{"given":"Xiaoming","family":"Lian","sequence":"first","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yigang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7218-0464","authenticated-orcid":true,"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, et al. 2018 ACC\/AHA\/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019; 140: e382\u2013e482.","DOI":"10.1161\/CIR.0000000000000628"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Gabet A, Lailler G, Fauchier L, Deharo JC, Tuppin P, Leclercq C, et al. Epidemiology of major heart rhythm and conduction disorders. Archives of Cardiovascular Diseases. 2024; 117: 693\u2013704.","DOI":"10.1016\/j.acvd.2024.10.003"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Zhang J, Liu J, Ye M, Zhang M, Yao F, Cheng Y. Incidence and risk factors associated with atrioventricular block in the general population: the atherosclerosis risk in communities study and Cardiovascular Health Study. BMC Cardiovascular Disorders. 2024; 24: 509.","DOI":"10.1186\/s12872-024-04163-9"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Francula-Zaninovic S, Nola IA. Management of Measurable Variable Cardiovascular Disease\u2019 Risk Factors. Current Cardiology Reviews. 2018; 14: 153\u2013163.","DOI":"10.2174\/1573403X14666180222102312"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Goorani S, Zangene S, Imig JD. Hypertension: A Continuing Public Healthcare Issue. International Journal of Molecular Sciences. 2024; 26: 123.","DOI":"10.3390\/ijms26010123"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Varvarousis D, Kallistratos M, Poulimenos L, Triantafyllis A, Tsinivizov P, Giannakopoulos A, et al. Cardiac arrhythmias in arterial hypertension. Journal of Clinical Hypertension. 2020; 22: 1371\u20131378.","DOI":"10.1111\/jch.13989"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Tannenbaum L, Long B. Electrocardiogram essentials: Bradycardia. The American Journal of Emergency Medicine. 2025; 97: 58\u201364.","DOI":"10.1016\/j.ajem.2025.07.030"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Sabio R, Valdez P, Casariego Vales E, C\u00e1mera L, Puello Galarcio HL, Camafort M, et al. Executive summary of the 2025 consensus on the diagnosis and treatment of hypertension of the International Forum on Internal Medicine. Revista Clinica Espanola. 2025; 225: 502368.","DOI":"10.1016\/j.rceng.2025.502368"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Chinese Society of Cardiology, Chinese Medical Association; Hypertension Committee of Cross-Straits Medicine Exchange Association; Cardiovascular Disease Prevention and Rehabilitation Committee, Chinese Association of Rehabilitation Medicine. Clinical practice guideline for the management of hypertension in China. Chinese Medical Journal. 2024; 137: 2907\u20132952.","DOI":"10.1097\/CM9.0000000000003431"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Ponnusamy SS, Arora V, Namboodiri N, Kumar V, Kapoor A, Vijayaraman P. Left bundle branch pacing: A comprehensive review. Journal of Cardiovascular Electrophysiology. 2020; 31: 2462\u20132473.","DOI":"10.1111\/jce.14681"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Chow CLD, Wong C, Sutherland N, Obeyesekere MN, Wong GR, Eastwood CM, et al. Clinical Outcomes of Conduction System Pacing vs Right Ventricular Septal Pacing in Atrioventricular Block: The CSPACE Randomized Controlled Trial. Journal of the American College of Cardiology. 2025; 86: 563\u2013573.","DOI":"10.1016\/j.jacc.2025.06.043"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Miyajima K, Urushida T, Tamura T, Masuda S, Okazaki A, Takashima Y, et al. Assessing cardiac mechanical dyssynchrony in left bundle branch area pacing and right ventricular septal pacing using myocardial perfusion scintigraphy in the acute phase of pacemaker implantation. Journal of Cardiovascular Electrophysiology. 2022; 33: 1826\u20131836.","DOI":"10.1111\/jce.15609"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Liu P, Wang Q, Sun H, Qin X, Zheng Q. Left Bundle Branch Pacing: Current Knowledge and Future Prospects. Frontiers in Cardiovascular Medicine. 2021; 8: 630399.","DOI":"10.3389\/fcvm.2021.630399"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Briongos Figuero S, Estevez Paniagua A, Tapia Martinez M, Jimenez Loeches S, Sanchez Hernandez A, Heredero D, et al. Sustained electrical synchrony with left bundle branch area pacing: results at long-term follow-up. Europace. 2025; 27: euaf085.534.","DOI":"10.1093\/europace\/euaf085.534"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Wang JG. Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 revision). Journal of Geriatric Cardiology. 2025; 22: 1\u2013149.","DOI":"10.26599\/1671-5411.2025.01.008"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Haghjoo M. Bradyarrhythmias. In Maleki M, Alizadehasl A, Haghjoo M (eds.) Practical Cardiology (Second Edition) (pp. 289\u2013296). Elsevier: Amsterdam. 2022.","DOI":"10.1016\/B978-0-323-80915-3.00009-0"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Schaefer J, Sch\u00f6ttler M. The treatment of excessive arterial hypertension by a permanent cardiac pacemaker system: a case report concerning the possibility to influence the disturbed harmonization between the heart and the arterial system (author\u2019s transl). Klinische Wochenschrift. 1976; 54: 277\u2013281.  (In German)","DOI":"10.1007\/BF01468923"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Gallo G, Savoia C. Hypertension and Heart Failure: From Pathophysiology to Treatment. International Journal of Molecular Sciences. 2024; 25: 6661.","DOI":"10.3390\/ijms25126661"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Masenga SK. Ventricular-Arterial Coupling and Hypertension: Integrating Vascular and Cardiac Indices. American Journal of Hypertension. 2025; 38: 875\u2013877.","DOI":"10.1093\/ajh\/hpaf147"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Gao T, Li Z, Li W, Wang X, Xie X. The Risk of New-Onset Atrial Fibrillation in Patients With Conduction System Pacing Versus Right Ventricular Pacing: A Meta-Analysis. Reviews in Cardiovascular Medicine. 2025; 26: 27921.","DOI":"10.31083\/RCM27921"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Li F, Zhang Y, Huang J, Peng SL, Jin MC, Geng C, et al. Lower Risk of New-Onset Atrial Fibrillation in Conduction System Pacing Compared With Right Ventricular Pacing. Pacing and Clinical Electrophysiology. 2025; 48: 202\u2013215.","DOI":"10.1111\/pace.15121"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Harbin MM, Brown CD, Burns KV, Espinoza EA, Dengel DR, Bank AJ. QRS morphology and electrical dyssynchrony in patients before and after cardiac resynchronization therapy and after device optimization. Journal of Electrocardiology. 2025; 92: 154086.","DOI":"10.1016\/j.jelectrocard.2025.154086"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Borgquist R, Marinko S, Platonov PG, Wang L, Chaudhry U, Brandt J, et al. Maximizing QRS duration reduction in contemporary cardiac resynchronization therapy is feasible and shorter QRS duration is associated with better clinical outcome. Journal of Interventional Cardiac Electrophysiology. 2023; 66: 1799\u20131806.","DOI":"10.1007\/s10840-022-01463-y"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Sales-Belles C, Minchol\u00e9 A, Melero-Polo J, Cabrera-Ramos M, Vadillo-Mart\u00edn P, Montilla-Padilla I, et al. ECG-based evaluation of ventricular synchrony in left bundle branch area pacing through characterization of the activation sequence. Scientific Reports. 2025; 15: 15584.","DOI":"10.1038\/s41598-025-98608-6"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Hua W, Fan X, Li X, Niu H, Gu M, Ning X, et al. Comparison of Left Bundle Branch and His Bundle Pacing in Bradycardia Patients. JACC. Clinical Electrophysiology. 2020; 6: 1291\u20131299.","DOI":"10.1016\/j.jacep.2020.05.008"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Wu X, Hu W, Song L, Chen W, Zhou Y, Zhou L, et al. Use of acoustic cardiography to assess left ventricular electromechanical synchronization during left bundle branch pacing. Heart Rhythm O2. 2023; 4: 632\u2013640.","DOI":"10.1016\/j.hroo.2023.08.009"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Huang J, Guo L, Zhang W, Li R, He B. Left bundle branch potential predicts better electrical synchrony in bradycardia patients receiving left bundle branch pacing. BMC Cardiovascular Disorders. 2022; 22: 376.","DOI":"10.1186\/s12872-022-02812-5"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/6\/10.31083\/BJHM54928","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:59:11Z","timestamp":1783421951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/6\/10.31083\/BJHM54928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)03000-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm54928","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"54928"}}