{"doi":"10.1016/j.hrthm.2025.12.018","title":"QRS duration, left bundle branch block morphology, and outcomes among patients who undergo septal myectomy","abstract":null,"journal":"Heart Rhythm","year":2026,"id":637843,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1656375,"name":"Jingang Cui","orcid":null,"position":1,"is_corresponding":false},{"id":1656377,"name":"Xinli Guo","orcid":null,"position":2,"is_corresponding":false},{"id":1526057,"name":"Xinxin Zheng","orcid":null,"position":3,"is_corresponding":false},{"id":1656380,"name":"Changrong Nie","orcid":null,"position":4,"is_corresponding":false},{"id":1151425,"name":"Tao Lu","orcid":"0000-0003-1783-6018","position":5,"is_corresponding":false},{"id":1656382,"name":"Qiulan Yang","orcid":null,"position":6,"is_corresponding":false},{"id":1656384,"name":"Shuiyun Wang","orcid":null,"position":7,"is_corresponding":false},{"id":1400831,"name":"Xiaohong Huang","orcid":"0000-0001-8274-5070","position":8,"is_corresponding":false},{"id":1656373,"name":"Changpeng Song","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"QRS duration, left bundle branch block morphology, and outcomes among patients who undergo septal myectomy","abstract":"<h4>Background</h4>The clinical impact of new-onset left bundle branch block (LBBB) and QRS duration after septal myectomy remains unclear.<h4>Objective</h4>This study investigated effects of LBBB morphology and QRS duration on long-term outcomes after septal myectomy.<h4>Methods</h4>This study analyzed 1655 patients with hypertrophic cardiomyopathy (HCM) without preoperative conduction disorders who underwent septal myectomy. Patients were stratified into 3 groups according to the postoperative QRS features: no LBBB, LBBB with QRS <150 milliseconds, and LBBB with QRS ≥150 milliseconds. Outcomes included mortality, permanent pacemaker implantation, and left ventricular systolic dysfunction (LVSD, left ventricular ejection fraction <50%). Cox models adjusted for clinical and echocardiographic variables assessed risk.<h4>Results</h4>LBBB occurred in 50% of patients. During 55-month follow-up, LBBB and QRS ≥150 milliseconds was associated with highest risks of all-cause mortality (adjusted HR = 2.17, 95% CI 1.12-4.20; P = .022) and pacemaker implantation (adjusted HR = 4.36, 95% CI 1.69-11.29; P = .002), compared with those without LBBB. Five-year survival free from mortality was lowest in the LBBB and QRS ≥150 milliseconds group (97.2% vs 98.0% and 98.9% in no LBBB and LBBB and QRS <150 milliseconds groups; P < .001). LVSD risk was higher in patients with LBBB and QRS ≥150 milliseconds (adjusted HR 7.04, 95% CI 3.00-16.50; P < .001) than in those without LBBB.<h4>Conclusion</h4>In conclusion, although overall survival remains excellent, new-onset LBBB with QRS ≥150 milliseconds after septal myectomy identifies an HCM subgroup at higher risk for LVSD, warranting closer monitoring and timely intervention.","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41397498","pmcid":null,"openalex_id":"https://openalex.org/W4417299140","authors":[],"funders":[{"funder_name":"Chinese Academy of Medical Sciences Initiative for Innovative Medicine","grant_id":"2023-I2M-1-001","title":null},{"funder_name":"National Natural Science Foundation of China","grant_id":"","title":null},{"funder_name":"China Academy of Chinese Medical Sciences","grant_id":"","title":null}],"total_grants":3,"fwci":1.5034,"citation_percentile":0.86428562,"influential_citations":0,"citation_trend":[{"year":2026,"count":2}],"oa_status":"closed","license":"https://www.elsevier.com/legal/tdmrep-license","oa_locations":[{"url":"https://api.elsevier.com/content/article/PII:S154752712503156X?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S154752712503156X?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.hrthm.2025.12.018","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41397498","host_type":"repository"}],"fields_of_study":["Cardiac pacing and defibrillation studies","Acute Myocardial Infarction Research","Cervical and Thoracic Myelopathy","Female","Humans","Male","Middle Aged","Bundle-Branch Block","Cardiomyopathy, Hypertrophic","Echocardiography","Electrocardiography","Follow-Up Studies","Heart Conduction System","Heart Septum","Retrospective Studies","Septal Myectomy","Treatment Outcome","Ventricular Function, Left"],"mesh_terms":["Septal Myectomy","Bundle-Branch Block","Cardiomyopathy, Hypertrophic","Echocardiography","Electrocardiography","Female","Follow-Up Studies","Heart Conduction System","Heart Septum","Humans","Male","Middle Aged","Retrospective Studies","Ventricular Function, Left","Treatment Outcome"],"keywords":["Left bundle branch block","Septal myectomy","QRS complex","Bundle branch block","Obstructive hypertrophic cardiomyopathy","Hypertrophic cardiomyopathy","Pacemaker","Outcomes","Qrs Duration","Lvsd"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T19:38:02.040407Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}