Key result
AV delay optimization inducing RV pacing worsens GLS ~25% despite improving diastolic filling in LBBB.
Why the study?
The acute effects of transitioning from intrinsic LBBB to RV-paced activation during programming optimization remain incompletely understood in patients who may not be good candidates for pacemaker upgrades.
Does AV delay optimization inducing RV capture improve hemodynamics and myocardial mechanics in a patient with intrinsic LBBB?
Case Report (n=1)
Does AV delay optimization inducing RV capture improve hemodynamics and myocardial mechanics in a patient with intrinsic LBBB?
RV pacing via AV delay optimization in a patient with intrinsic LBBB improved diastolic filling but worsened myocardial efficiency as measured by global longitudinal strain.
Acute RV pacing effects in legacy devices may guide individualized programming; leaves open prospective studies on LV function.
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Tasneem Z. Naqvi (2026) conducted a case report in Dilated cardiomyopathy with intrinsic left bundle branch block (n=1). Atrioventricular (AV) delay optimization inducing right ventricular (RV) capture vs. Baseline (intrinsic LBBB with long programmed AV delay) was evaluated on Global longitudinal strain (GLS). AV delay optimization inducing RV pacing improved diastolic filling time (from 30% to 50% of R-R interval) but worsened global longitudinal strain (from -11.0% to -8.3%) in a patient with LBBB.
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