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Updated: Jul 12, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Published on: December 11, 2017

Early Left Ventricular Mechanical Dyssynchrony Predicts Left Atrial Dysfunction Following Right Ventricular Pacing.

Ismail Mohamed Ibrahim¹, Shehab Ezzat Ahmed Talaat¹, Tarek Ahmed Naguib¹

¹Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Echocardiography (Mount Kisco, N.Y.)

|July 11, 2026

Summary

Right ventricular pacing can lead to impaired left atrial mechanics. Early left ventricular mechanical dispersion (LVMD) predicts this dysfunction, identifying patients at risk for heart failure before symptoms appear.

Keywords:

left atrial mechanics left atrial reservoir strain left ventricular dyssynchrony left ventricular mechanical dispersion right ventricular pacing speckle‐tracking echocardiography

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Area of Science:

Cardiology
Echocardiography
Cardiac Mechanics

Background:

Left atrial reservoir strain (LASr) indicates left atrial (LA) mechanical function.
Impaired LASr may precede heart failure with preserved ejection fraction (HFpEF) in patients with conventional right ventricular (RV) pacing.
Early detection of LA dysfunction is crucial in these patients.

Purpose of the Study:

To identify early predictors of impaired LASr at 12 months after conventional RV pacing.
To investigate the relationship between left ventricular (LV) mechanical dispersion (LVMD) and subsequent LA dysfunction.
To assess the role of LVMD in predicting adverse atrial remodeling.

Main Methods:

Prospective enrollment of 52 patients undergoing conventional RV pacing.
Transthoracic echocardiography (TTE) performed at baseline, 3, and 12 months.
Assessment of LVMD, LV global longitudinal strain (LVGLS), diastolic function, and LA strain parameters.
Stratification of patients based on 12-month LASr (<25% defined impaired LA mechanics).

Main Results:

36.5% of patients developed impaired LA mechanics at 12 months.
At 3 months, impaired LA mechanics group showed higher LVMD (p < 0.001), reduced LVGLS (p = 0.03), and higher E/e' (p = 0.04).
3-month LVMD independently predicted impaired LASr at 12 months (OR 2.04, p = 0.01) with high discriminatory performance (AUC 0.84).

Conclusions:

Early LVMD precedes overt atrial dysfunction in patients with conventional RV pacing.
LVMD is an independent predictor of subsequent LA mechanical impairment.
LVMD may identify patients at risk for adverse atrial remodeling and potential heart failure development.