ArticleJournal of arrhythmia2026
Improvement of Microvascular Ischemia by Atrioventricular Sequential Pacing in Non-Obstructive Hypertrophic Cardiomyopathy.
Article in Journal of arrhythmia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Therapeutic options for symptomatic non-obstructive hypertrophic cardiomyopathy (nHCM) remain limited. We investigated whether right ventricular apical (RVA) pacing with optimal atrioventricular delay (AVD) can improve myocardial oxygen supply-demand mismatch, assessed using coronary sinus (CS) lactate as a marker of microvascular ischemia. Methods: Patients underwent atrial pacing at 70% of target heart rate followed by AV sequential pacing at individually optimized AVD. CS lactate levels were measured at baseline, during atrial pacing, after washout, and during AV sequential pacing. Results: Baseline CS lactate was 0.55 ± 0.15 mmol/L and increased to 1.13 ± 0.29 mmol/L during atrial pacing. After washout, levels returned to near baseline (0.59 ± 0.21 mmol/L). During AV sequential pacing at optimal AVD (142.8 ± 20.6 ms), CS lactate decreased to 0.86 ± 0.31 mmol/L, showing a significant reduction compared to atrial pacing ( Conclusions: AV sequential pacing at optimized AVD reduces CS lactate during exertion in most patients with nHCM, suggesting improved myocardial oxygen balance and reduced microvascular ischemia.
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