{ "abstract": "BACKGROUND: Left bundle branch area pacing may reduce new-onset atrial fibrillation. However, its mechanism and the comparison of atrial reverse remodeling effect between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) has not been elucidated. We aim to investigate reverse atrial remodeling by LBBP and LVSP in a canine model of rapid pacing-induced dyssynchronous heart failure (DHF). METHODS: Twenty-six beagles followed a 6-week protocol: controls (n=4), rapid atrial pacing (n=4), DHF (n=6), DHF+LBBP and DHF+LVSP (3 weeks DHF followed by 3 weeks LBBP or LVSP, both n=6). Atrial emptying fraction, functional, and electrophysiological parameters were dynamically assessed. Atrial fibrosis was analyzed in tissue samples. RESULTS: Within 3 weeks DHF increased atrial volumes and diminished RA and LA emptying fraction and strains significantly compared with baseline. Subsequent 3 weeks of LBBP increased emptying fraction and strains significantly. At week 6, P-wave duration was shorter in DHF+LBBP than in DHF. Atrial fibrillation was only inducible in DHF animals. Left atrial appendage levels of collagen I/III and α-SMA deposition and fibrosis were lower in DHF+LBBP compared with DHF animals. LBBP reversed atrial structural and electrical parameters to the levels in rapid atrial pacing animals. LVSP improved those parameters compared with those in DHF but did not normalize them to the levels in the rapid atrial pacing animals. CONCLUSIONS: LBBP significantly reverses DHF-induced functional, cellular, and molecular remodeling in the atria, while a smaller amelioration is achieved with LVSP. The findings may explain the reduction in new-onset atrial fibrillation after LBBP.", "abstract_shown": true, "affiliations": [ "Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University", "National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences", "School of Basic Medical Sciences, Capital Medical University", "National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College", "The Cardiac Arrhythmia Center, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College", "Peking University First Hospital", "Maastricht University Medical Center, Cardiovascular Research Institute Maastricht (CARIM)", "Cardiovascular Research Institute (CARIM), Maastricht University" ], "article_type": null, "arxiv": null, "author_total": 25, "authors": [ { "affs": [ 0, 1 ], "name": "Sixian Weng" }, { "affs": [ 2 ], "name": "Jianqiu Pei", "orcid": "0000-0002-7935-0884" }, { "affs": [ 3 ], "name": "Hui Li" }, { "affs": [ 4 ], "name": "Sijing Cheng", "orcid": "0000-0003-0837-0826" }, { "affs": [ 4 ], "name": "Hao Huang" }, { "affs": [ 5 ], "name": "Han Jin", "orcid": "0000-0003-0148-9031" }, { "affs": [ 4 ], "name": "Yu Jiang", "orcid": "0000-0002-2797-1099" }, { "affs": [ 4 ], "name": "Juwei Yang" }, { "affs": [ 4 ], "name": "Guanzhi Chen" }, { "affs": [ 3 ], "name": "Liang Chen", "orcid": "0000-0001-6374-112X" }, { "affs": [ 4 ], "name": "Min Gu", "orcid": "0000-0001-7991-6860" }, { "affs": [ 4 ], "name": "Jing Wang" }, { "affs": [ 5 ], "name": "Pengkang He", "orcid": "0000-0003-2680-8457" }, { "affs": [ 4 ], "name": "Bingqi Fu" }, { "affs": [ 0 ], "name": "Jiawei Zhang" }, { "affs": [ 0 ], "name": "Yanguang Li", "orcid": "0000-0002-9121-1887" }, { "affs": [ 0 ], "name": "Qiaoyuan Li", "orcid": "0000-0002-8157-7949" }, { "affs": [ 0 ], "name": "Xu Liu" }, { "affs": [ 0 ], "name": "Tao Zhang", "orcid": "0000-0002-7618-2563" }, { "affs": [ 0 ], "name": "Yunlong Wang", "orcid": "0000-0001-5695-5058" }, { "affs": [ 4 ], "name": "Yiran Hu", "orcid": "0000-0002-6588-9037" }, { "affs": [ 1 ], "name": "Fang Wang", "orcid": "0000-0002-6674-5537" }, { "affs": [ 6 ], "name": "Kevin Vernooy", "orcid": "0000-0002-8818-5964" }, { "affs": [ 7 ], "name": "Frits W. Prinzen", "orcid": "0000-0001-8917-9032" }, { "affs": [ 4 ], "name": "Wei Hua", "orcid": "0000-0001-6921-9375" } ], "bibtex": "https://research.draconitic.com/paper/6tv4gss9h0ctr.bib", "cited_by": 0, "doi": "10.1161/jaha.125.048379", "fulltext_url": null, "id": "6tv4gss9h0ctr", "issns": [ "2047-9980" ], "landing_url": "https://www.ahajournals.org/doi/10.1161/JAHA.125.048379", "language": null, "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2705|Cardiac pacing and defibrillation studies" ] ], "openalex": "W7221361902", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-10-20", "publisher": "Ovid Technologies (Wolters Kluwer Health)", "ris": "https://research.draconitic.com/paper/6tv4gss9h0ctr.ris", "sources": [ { "first_seen": "2026-10-30T12:20:28Z", "native_id": "10.1161/jaha.125.048379", "source": "crossref", "url": "https://www.ahajournals.org/doi/10.1161/JAHA.125.048379" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Cardiac pacing and defibrillation studies", "subfield": "cardiovascular" } ], "title": "Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model", "title_text": "Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:28Z", "url": "https://research.draconitic.com/paper/6tv4gss9h0ctr", "venue": "Journal of the American Heart Association", "versions": [] }