Study population
This was a retrospective study. Consecutive patients with a pacemaker indication who underwent successful LBBAP were identified from the First Affiliated Hospital of Nanjing Medical University between July 2018 and March 2023. Patients who met the following criteria were included: 1) persistent AF; 2) mean heart rate (HR) < 60 bpm; 3) moderate or severe FTR. Patients with tricuspid valve replacement surgery, primary tricuspid valvular diseases[16] and lost follow-up (defined as without having a follow-up of both one week and 6 months) were excluded. Patients with heart failure and complete left bundle branch block who were candidates for cardiac resynchronization therapy (CRT) were also excluded [17]. All the patients included in the study were provided with written informed consent. And the study protocol was approved by the Institutional Review Board of the First Affiliated Hospital of Nanjing Medical University.