Why the study?
Does His-bundle pacing improve left ventricular synchronization and ejection fraction compared with right ventricle pacing in pacemaker dependent and heart failure patients?
Does His-bundle pacing improve left ventricular synchronization and ejection fraction compared with right ventricle pacing in pacemaker dependent and heart failure patients?
His-bundle pacing is a viable physiological alternative to right ventricular pacing that improves electrical/mechanical synchronization and LVEF, particularly benefiting patients with high pacing dependence or LVEF impairment.
Supports His-bundle pacing over RV pacing for LV synchronization and LVEF; extends physiological evidence while mortality benefit remains unresolved.
His-bundle pacing (HBP) appears to be a viable stand-alone or adjunctive physiological pacing therapy in pacemaker dependent patients. It could also serve as an effective adjunct or alternative pacing therapy for heart failure patients who require cardiac resynchronization therapy or pacemaker upgrade. His-bundle pacing has demonstrated improvement of His-Purkinje conduction, left ventricular electrical / mechanical synchronization, and left ventricular ejection fraction (LVEF) compared with right ventricle pacing. Patients who have high pacing dependence and/or LVEF impairment would benefit most from HBP in terms of heart failure hospitalization and LVEF improvement. Mortality benefit has not been consistently demonstrated in latest meta-analysis. The long-term clinical benefit and safety profile of HBP remains to be explored in future studies.
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Chan et al. (2021) studied this question.
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