HIS Alternative II
His bundle pacing versus biventricular pacing in patients with heart failure
Presented by Michael Vinther
Subspecialty: Devices & Arrhythmias
Published in JACC Clinical Electrophysiology
Key Result
His/LBB pacing was noninferior to biventricular pacing for left ventricular reverse remodeling: LVESV decreased 35% with His/LBB pacing versus 34% with biventricular pacing.
What did this trial find?
The HIS Alternative II trial compared His bundle pacing versus biventricular pacing in patients with heart failure, presented by Michael Vinther.
Abstract
HIS Alternative II compared conduction-system pacing (His bundle or left bundle branch) with biventricular pacing in patients with heart failure and typical left bundle branch block. The primary endpoint was change in left ventricular end-systolic volume. LVESV fell 35% with His/LBB pacing versus 34% with biventricular pacing, and the trial met its noninferiority criterion. Presented in Hot Line 10 at ESC Congress 2026 with simultaneous publication in JACC: Clinical Electrophysiology (10.1016/j.jacep.2026.08.008).