Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model
8 affiliations
- 1Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University
- 2National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences
- 3School of Basic Medical Sciences, Capital Medical University
- 4National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- 5The 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
- 6Peking University First Hospital
- 7Maastricht University Medical Center, Cardiovascular Research Institute Maastricht (CARIM)
- 8Cardiovascular Research Institute (CARIM), Maastricht University
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.
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BibTeX
@article{weng2026left,
title = {{Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model}},
author = {Sixian Weng and Jianqiu Pei and Hui Li and Sijing Cheng and Hao Huang and Han Jin and Yu Jiang and Juwei Yang and Guanzhi Chen and Liang Chen and Min Gu and Jing Wang and Pengkang He and Bingqi Fu and Jiawei Zhang and Yanguang Li and Qiaoyuan Li and Xu Liu and Tao Zhang and Yunlong Wang and Yiran Hu and Fang Wang and Kevin Vernooy and Frits W. Prinzen and Wei Hua},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.125.048379},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.125.048379},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Left Bundle Branch Area Pacing Improves Atrial Function and Reverses Atrial Remodeling in Dyssynchrony Heart Failure Model
AU - Sixian Weng
AU - Jianqiu Pei
AU - Hui Li
AU - Sijing Cheng
AU - Hao Huang
AU - Han Jin
AU - Yu Jiang
AU - Juwei Yang
AU - Guanzhi Chen
AU - Liang Chen
AU - Min Gu
AU - Jing Wang
AU - Pengkang He
AU - Bingqi Fu
AU - Jiawei Zhang
AU - Yanguang Li
AU - Qiaoyuan Li
AU - Xu Liu
AU - Tao Zhang
AU - Yunlong Wang
AU - Yiran Hu
AU - Fang Wang
AU - Kevin Vernooy
AU - Frits W. Prinzen
AU - Wei Hua
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.125.048379
UR - https://www.ahajournals.org/doi/10.1161/JAHA.125.048379
AB - 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.
SN - 2047-9980
ER -