ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2022
Pacing therapy for atrioventricular dromotropathy: a combined computational-experimental-clinical study.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Left atrioventricular coupling index in patients undergoing cardiac resynchronization therapy.The international journal of cardiovascular imaging · 2026Trial
- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- Atrioventricular Delay Optimization in His-Optimized Cardiac Resynchronization Therapy: A Case Report.Clinical case reports · 2026Article
- Clinical Utility of Atrioventricular Coupling Index in Cardiovascular Disease.Journal of the American Heart Association · 2025Review
- Impact of myocardial phenotype on optimal atrioventricular delay settings during biventricular and left bundle branch pacing at rest and during exercise: insights from a virtual patient study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Accelerated atrial pacing reduces left-heart filling pressure: a combined clinical-computational study.European heart journal · 2024Article
- Early effects of left bundle branch area pacing on ventricular activation by speckle tracking echocardiography.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- PR Interval as a Novel Therapeutic Target of Ivabradine Therapy-Prognostic Impact of Ivabradine-Induced PR Prolongation in Heart Failure Patients.Journal of clinical medicine · 2024Article
- Pacemaker-induced atrial fibrillation reconsidered-associations with different pacing sites and prevention approaches.Frontiers in cardiovascular medicine · 2024Review
- Prognostic implications of invasive hemodynamics during cardiac resynchronization therapy: Stroke work outperforms dP/dtHeart rhythm O2 · 2023Article
- Frontiers in conduction system pacing: treatment of long PR in patients with heart failure.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Electrocardiogram-based deep learning improves outcome prediction following cardiac resynchronization therapy.European heart journal · 2023Article
- Electrical management of heart failure: from pathophysiology to treatment.European heart journal · 2022Review
- Atrioventricular dromotropathy: an important substrate for complete resynchronization therapy-Authors' reply.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022Article
- Electro-energetics of Biventricular, Septal and Conduction System Pacing.Arrhythmia & electrophysiology review · 2021Review
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Authors and funding
16 authors at 7 institutions in 3 countries.
Funding
Abstract
aimsInvestigate haemodynamic effects, and their mechanisms, of restoring atrioventricular (AV)-coupling using pacemaker therapy in normal and failing hearts in a combined computational-experimental-clinical study. METHODS AND
resultsComputer simulations were performed in the CircAdapt model of the normal and failing human heart and circulation. Experiments were performed in a porcine model of AV dromotropathy. In a proof-of-principle clinical study, left ventricular (LV) pressure and volume were measured in 22 heart failure (HF) patients (LV ejection fraction <35%) with prolonged PR interval (>230 ms) and narrow or non-left bundle branch block QRS complex. Computer simulations and animal studies in normal hearts showed that restoring of AV-coupling with unchanged ventricular activation sequence significantly increased LV filling, mean arterial pressure, and cardiac output by 10-15%. In computer simulations of failing hearts and in HF patients, reducing PR interval by biventricular (BiV) pacing (patients: from 300 ± 61 to 137 ± 30 ms) resulted in significant increases in LV stroke volume and stroke work (patients: 34 ± 40% and 26 ± 31%, respectively). However, worsening of ventricular dyssynchrony by using right ventricular (RV) pacing abrogated the benefit of restoring AV-coupling. In model simulations, animals and patients, the increase of LV filling and associated improvement of LV pump function coincided with both larger mitral inflow (E- and A-wave area) and reduction of diastolic mitral regurgitation.
conclusionRestoration of AV-coupling by BiV pacing in normal and failing hearts with prolonged AV conduction leads to considerable haemodynamic improvement. These results indicate that BiV or physiological pacing, but not RV pacing, may improve cardiac function in patients with HF and prolonged PR interval.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.