{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:46:44Z","timestamp":1793393204630,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"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>Background<\/jats:title><jats:p>Left bundle branch pacing (LBBP) is an emerging physiological pacing modality. Left ventricular (LV) myocardial work (MW) incorporates afterload and LV global longitudinal strain to estimate global and segmental myocardial contractility. However, the effect of LBBP on LV MW remains unknown. This study aimed to evaluate the impact of LBBP on LV MW in patients receiving pacemaker for bradyarrhythmia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively enrolled 70 bradycardia patients with normal LV systolic function receiving LBBP (<jats:italic>n<\/jats:italic>\u2009=\u200946) and non-selective His-bundle pacing (NS-HBP) (<jats:italic>n<\/jats:italic>\u2009=\u200924). For comparative analysis, patients receiving right ventricular pacing (RVP) (<jats:italic>n<\/jats:italic>\u2009=\u200916) and control subjects (<jats:italic>n<\/jats:italic>\u2009=\u200910) were enrolled. Two-dimensional speckle tracking echocardiography was performed. The LV pressure-strain loop was non-invasively constructed to assess global LV MW.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 6-month follow-up, LBBP group (with &amp;gt;40% ventricular pacing during 6 months) had shorter peak strain dispersion (PSD) compared with RVP group, and higher LV global longitudinal strain compared with RVP group and NS-HBP group, but had no difference in left intraventricular mechanical dyssynchrony, including septal-to-posterior wall motion delay and PSD, compared with NS-HBP group. During ventricular pacing, LBBP group had higher global MW index (GWI) (2,189\u2009\u00b1\u2009527 vs. 1,493\u2009\u00b1\u2009799\u2005mmHg%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), higher global constructive work (GCW) (2,921\u2009\u00b1\u2009771 vs. 2,203\u2009\u00b1\u2009866\u2005mmHg%, <jats:italic>P<\/jats:italic>\u2009=\u20090.009), lower global wasted work (GWW) (211\u2009\u00b1\u2009161 vs. 484\u2009\u00b1\u2009281\u2005mmHg%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) and higher global MW efficiency (GWE) (91.4\u2009\u00b1\u20095.0 vs. 80.9\u2009\u00b1\u20098.3%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) compared with RVP group, and had lower GWW (211\u2009\u00b1\u2009161 vs. 406\u2009\u00b1\u2009234\u2005mmHg%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) and higher GWE (91.4\u2009\u00b1\u20095.0 vs. 86.4\u2009\u00b1\u20098.1%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) compared with NS-HBP group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study we found that in patients with mid-term (6-month) high ventricular pacing burden (&amp;gt;40%), LBBP preserved more LV MW compared with NS-HBP and RVP. Further studies are warranted to assess the association between LV MW and long-term clinical outcomes in LBBP with high ventricular pacing burden.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1201841","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T01:33:21Z","timestamp":1694741601000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Left bundle branch pacing preserved left ventricular myocardial work in patients with bradycardia"],"prefix":"10.3389","volume":"10","author":[{"given":"Huang-Chung","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Lung","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chieh","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Nan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaur-Zheng","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mien-Cheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3115","DOI":"10.1001\/jama.288.24.3115","article-title":"Dual chamber and VVI implantable defibrillator trial investigators. Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the dual chamber and VVI implantable defibrillator (DAVID) trial","volume":"288","author":"Wilkoff","year":"2002","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","article-title":"Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction","volume":"107","author":"Sweeney","year":"2003","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.jacc.2007.06.011","article-title":"Speckle-tracking radial strain reveals left ventricular dyssynchrony in patients with permanent right ventricular pacing","volume":"50","author":"Tops","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.echo.2010.03.006","article-title":"Right ventricular outflow tract pacing causes intraventricular dyssynchrony in patients with sick sinus syndrome: a real-time three-dimensional echocardiographic study","volume":"23","author":"Liu","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1111\/j.1540-8159.1999.tb00631.x","article-title":"Altered cardiac histology following apical right ventricular pacing in patients with congenital atrioventricular block","volume":"22","author":"Karpawich","year":"1999","journal-title":"Pacing Clin Electrophysiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/j.amjcard.2005.11.044","article-title":"Ventricular remodeling during long-term right ventricular pacing following his bundle ablation","volume":"97","author":"Vernooy","year":"2006","journal-title":"Am J Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1016\/j.hrthm.2016.03.040","article-title":"How to perform permanent his bundle pacing in routine clinical practice","volume":"13","author":"Dandamudi","year":"2016","journal-title":"Heart Rhythm"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1016\/j.hrthm.2019.06.016","article-title":"A beginner\u2019s guide to permanent left bundle branch pacing","volume":"16","author":"Huang","year":"2019","journal-title":"Heart Rhythm"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1562","DOI":"10.1002\/clc.23481","article-title":"Assessment of ventricular mechanical synchronization after left bundle branch pacing using 2-D speckle tracking echocardiography","volume":"43","author":"Sun","year":"2020","journal-title":"Clin Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1111\/pace.14331","article-title":"Comparison of synchronization between left bundle branch and his bundle pacing in atrial fibrillation patients: an intra-patient-controlled study","volume":"44","author":"Sheng","year":"2021","journal-title":"Pacing Clin Electrophysiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"727611","DOI":"10.3389\/fcvm.2021.727611","article-title":"Mechanical synchrony and myocardial work in heart failure patients with left bundle branch area pacing and comparison with biventricular pacing","volume":"20","author":"Liu","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s10554-022-02742-5","article-title":"Left bundle branch pacing on mechanical synchrony and myocardial work in bradycardia patients","volume":"39","author":"Wang","year":"2023","journal-title":"Int J Cardiovasc Imaging"},{"key":"B13","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1093\/eurheartj\/ehs016","article-title":"A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work","volume":"33","author":"Russell","year":"2012","journal-title":"Eur Heart J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1093\/ehjci\/jey131","article-title":"A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy","volume":"20","author":"Chan","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e012072","DOI":"10.1161\/CIRCIMAGING.120.012072","article-title":"Global left ventricular myocardial work efficiency and long-term prognosis in patients after ST-segment-elevation myocardial infarction","volume":"14","author":"Lustosa","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.ehj.2003.09.030","article-title":"Interventricular and intraventricular dyssynchrony are common in heart failure patients, regardless of QRS duration","volume":"25","author":"Ghio","year":"2004","journal-title":"Eur Heart J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/j.jacc.2003.08.038","article-title":"Intra-left ventricular electromechanical asynchrony. A new independent predictor of severe cardiac events in heart failure patients","volume":"43","author":"Bader","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.euje.2005.10.006","article-title":"Baseline echocardiographic characteristics of heart failure patients enrolled in a large European multicentre trial (CArdiac REsynchronisation Heart Failure study)","volume":"7","author":"Ghio","year":"2006","journal-title":"Eur J Echocardiogr"},{"key":"B20","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/jce.15350","article-title":"Differentiating left bundle branch pacing and left ventricular septal pacing: an algorithm based on intracardiac electrophysiology","volume":"33","author":"Chen","year":"2022","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/j.jacep.2021.02.018","article-title":"Evaluation of the criteria to distinguish left bundle branch pacing from left ventricular septal pacing","volume":"7","author":"Wu","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1093\/europace\/euab164","article-title":"The V6-V1 interpeak interval: a novel criterion for the diagnosis of left bundle branch capture","volume":"24","author":"Jastrz\u0119bski","year":"2022","journal-title":"Europace"},{"key":"B23","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/j.jacc.2009.06.006","article-title":"The effects of right ventricular apical pacing on ventricular function and dyssynchrony implications for therapy","volume":"54","author":"Tops","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"504","DOI":"10.6515\/ACS.202207_38(4).20220115A","article-title":"Delta increment in pacing QRS duration predicts cardiovascular mortality in patients with pre-existing bundle branch block receiving permanent pacemakers","volume":"38","author":"Chen","year":"2022","journal-title":"Acta Cardiol Sin"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1016\/j.jacc.2004.06.074","article-title":"Left ventricular function during and after right ventricular pacing","volume":"44","author":"Nahlawi","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1093\/eurheartj\/ehr118","article-title":"Deleterious effect of right ventricular apical pacing on left ventricular diastolic function and the impact of pre-existing diastolic disease","volume":"32","author":"Fang","year":"2011","journal-title":"Eur Heart J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.echo.2019.05.002","article-title":"Global left ventricular myocardial work efficiency in healthy individuals and patients with cardiovascular disease","volume":"32","author":"El Mahdiui","year":"2019","journal-title":"J Am Soc Echocardiogr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1093\/ehjci\/jeab153","article-title":"Impaired myocardial work efficiency in heart failure with preserved ejection fraction","volume":"22","author":"D\u2019Andrea","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.hrthm.2021.08.033","article-title":"Clinical outcomes of left bundle branch area pacing compared to right ventricular pacing: results from the Geisinger-Rush Conduction System Pacing Registry","volume":"19","author":"Sharma","year":"2022","journal-title":"Heart Rhythm"},{"key":"B30","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1161\/CIRCEP.109.882910","article-title":"Left ventricular septal and left ventricular apical pacing chronically maintain cardiac contractile coordination, pump function and efficiency","volume":"2","author":"Mills","year":"2009","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1201841\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T01:33:25Z","timestamp":1694741605000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1201841\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,14]]},"references-count":30,"alternative-id":["10.3389\/fcvm.2023.1201841"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1201841","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,14]]},"article-number":"1201841"}}