Key result
His bundle pacing with AVNA treats AF effectively despite higher complications and lower ~86% success.
Why the study?
High capture thresholds and backup lead pacing requirements limit the use of His bundle pacing, warranting an assessment of its efficacy and safety combined with AVNA compared with BVP and LBBP in AF.
Does His bundle pacing combined with atrioventricular node ablation improve LVEF, NYHA score, and QRS duration compared to biventricular pacing and left bundle branch pacing in patients with atrial fibrillation?
Meta-Analysis
Does His bundle pacing combined with atrioventricular node ablation improve LVEF, NYHA score, and QRS duration compared to biventricular pacing and left bundle branch pacing in patients with atrial fibrillation?
p-value: p=< 0.05
HBP combined with AVNA is effective for AF but is associated with a lower success rate and more complications, necessitating further trials to determine its superiority over BVP and LBBP.
INTRODUCTION AND OBJECTIVE: His bundle pacing (HBP) could replace failed biventricular pacing (BVP) in guidelines (IIa Indication), but the high capture thresholds and backup lead pacing requirements limit its development. We assessed the efficacy and safety of HBP combined with atrioventricular node ablation (AVNA) for atrial fibrillation (AF) and compared with BVP and left bundle branch pacing (LBBP). METHODS: We reviewed PubMed, Embase, Web of Science, and Cochrane Library databases on left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) score, QRS duration (QRSd), and pacing threshold. RESULTS: < 0.05). HBP had a lower success rate (85.97%) and more complications (16.1%). CONCLUSION: HBP combined with AVNA is effective for AF, despite having a lower success rate and more complications. Further trials are required to determine whether HBP is superior to BVP and LBBP.
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Xu et al. (2024) conducted a meta-analysis in Atrial fibrillation. His bundle pacing combined with atrioventricular node ablation vs. Biventricular pacing and left bundle branch pacing was evaluated on Success rate (p=< 0.05). His bundle pacing combined with atrioventricular node ablation is effective for atrial fibrillation, despite having a lower success rate (85.97%) and more complications (16.1%).
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