{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T17:45:07Z","timestamp":1770227107283,"version":"3.49.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The present study aimed to compare the effects of left bundle branch area pacing (LBBAP) on cardiac function and clinical outcomes in patients with left bundle branch block (LBBB) and left ventricular ejection fraction (LVEF) &amp;gt;35 vs. \u226435%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Thirty-six consecutive patients with LBBB and LVEF &amp;lt;50% were enrolled. All patients were followed up for a mean of 6 months. The successful LBBAP was defined as a paced QRS complex presented as right bundle branch block (RBBB) morphology and QRSd &amp;lt; 130 ms. Echocardiography parameters, pacing parameters and clinical outcomes were collected. The successful LBBAP was achieved in 77.8% of all cases (28\/36). In LVEF &amp;gt; 35% group (70 \u00b1 8 years, 9 male), the success rate was 81.0% (17\/21). QRSd significantly decreased from 174 \u00b1 23 ms to 108 \u00b1 13 ms (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). The pacing threshold and R-wave amplitude were 0.6 \u00b1 0.2 V @ 0.5 ms and 12 \u00b1 7 mV, respectively. In LVEF \u2264 35% group (69 \u00b1 5 years, 9 male), the success rate was 73.3% (11\/15) with QRSd decreasing from 188 \u00b1 25 ms to 107 \u00b1 11 ms (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). The hyperresponders to LBBAP (functional recovery and LVEF \u2265 50%) in LVEF &amp;gt; 35% group was 52.9%, which were almost twice of that in LVEF \u2264 35% group (33.3%). Whether patients had LBBAP or left ventricular septal pacing (LVSP), patients in the LVEF &amp;gt; 35% group showed significantly lower incidence of heart failure hospitalizations or death from any cause (hazard ratio in LVEF &amp;gt; 35% group, 0.22; 95%CI, 0.06 to 0.75, <jats:italic>P<\/jats:italic> = 0.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LBBAP can significantly shorten the QRSd and improve cardiac function in LBBB patients with either LVEF &amp;gt; 35 or \u2264 35%. LBBAP should be considered as an effective therapy for preventing the deterioration of cardiac function in early-stage heart failure patients with LBBB and LVEF &amp;gt; 35%.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.838708","type":"journal-article","created":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T06:20:45Z","timestamp":1647498045000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Outcomes of Permanent Left Bundle Branch Area Pacing in Patients With Left Bundle Branch Block and Left Ventricular Ejection Fraction &gt;35 vs. \u226435%"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhixin","family":"Jiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zenghong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chongchong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiujuan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qijun","family":"Shan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e240","DOI":"10.1161\/CIR.0b013e31829e8776","article-title":"2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on practice guidelines","volume":"128","author":"Writing Committee","year":"2013","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1093\/europace\/eut206","article-title":"2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC)","volume":"15","author":"European Heart Rhythm","year":"2013","journal-title":"Developed in collaboration with the European Heart Rhythm Association (EHRA). 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