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Shows that right ventricular apical and left bundle branch pacing induce distinct chamber remodeling in canine heart failure models, highlighting divergent patterns of compliance and fibrosis.
Background We investigated the similarities and differences between two experimental approaches using tachy‐pacing technology to induce desynchronized heart failure in canines. Methods A total of eight dogs were included in the experiment, four were tachy‐paced in right ventricle apex (RVAP) and 4 were paced in right atrium after the ablation of left bundle branch to achieve left bundle branch block (RAP+LBBB). Three weeks of follow‐up were conducted to observe the changes in cardiac function and myocardial staining was performed at the end of the experiment. Results Both experimental approaches successfully established heart failure with reduced ejection fraction models, with similar trends in declining cardiac function. The RAP+LBBB group exhibited a prolonged overall ventricular activation time, delayed left ventricular activation, and lesser impact on the right ventricle. The RVAP approach led to a reduction in overall right ventricular compliance and right ventricular enlargement. The RAP+LBBB group exhibited significant reductions in left heart compliance (LVGLS, %: RAP+LBBB −12.60 ± 0.12 to −5.93 ± 1.25; RVAP −13.28 ± 0.62 to −8.05 ± 0.63, p = 0.023; LASct, %: RAP+LBBB −15.75 ± 6.85 to −1.50 ± 1.00; RVAP −15.75 ± 2.87 to −10.05 ± 6.16, p = 0.035). Histological examination revealed more pronounced fibrosis in the left ventricular wall and left atrium in the RAP+LBBB group while the RVAP group showed more prominent fibrosis in the right ventricular myocardium. Conclusion Both approaches establish HFrEF models with comparable trends. The RVAP group shows impaired right ventricular function, while the RAP+LBBB group exhibits more severe decreased compliance and fibrosis in left ventricle.
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Jin et al. (2024) studied this question.
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