Key result
His bundle pacing substantially improves NYHA class, increases LVEF, and narrows QRS duration.
Why the study?
The basic electrocardiogram and echocardiographic characteristics of His bundle pacing have not been systematically defined.
Does His bundle pacing improve electrocardiogram characteristics and cardiac function compared to pre-operation baseline?
Meta-Analysis
Does His bundle pacing improve electrocardiogram characteristics and cardiac function compared to pre-operation baseline?
His bundle pacing significantly reduces QRS duration and improves left ventricular ejection fraction and NYHA functional class compared to baseline.
Supports His bundle pacing for better functional class and LVEF in indicated patients; reinforces physiologic pacing evidence from aggregated studies.
OBJECTIVE: Although His bundle pacing (HBP) has shown an improved therapeutic effect than conventional pacing in terms of reducing cardiovascular mortality, the basic characteristics of HBP has not been defined systematically. Therefore, a systematical review and meta-analysis on the HBP characteristics can be timely and favorable. In this study, we aimed to clarify the electrocardiogram and echocardiographic characteristics of the pre- and post-operation of HBP. METHODS: Patients with HBP were exclusively included in this study. By evaluating their electrocardiogram characteristics, echocardiographic parameters, and cardiac function, the therapeutic effect of HBP was assessed. RESULTS: A total of 23 studies were included in the analysis. The overall implant success rate for HBP was 83.64%. After HBP treatment, the paced QRS duration dropped from 147.73±19.46 ms to 116.84±17.32 ms (p<0.001). Left ventricular ejection fraction (LVEF) increased from 34.87%±9.62% to 46.40%±9.64% (p<0.001), and NYHA functional class improved from 2.90±0.57 to 1.78±0.58 within the HBP group (SMD-2.09; 95% CI-2.53,-1.64, p<0.001). CONCLUSION: HBP can significantly reduce the QRS duration, resulting in improvement of cardiac function in most patients. In addition, this approach is applicable to most patients without limitations.
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Li et al. (2021) conducted a meta-analysis in Patients requiring pacing. His bundle pacing (HBP) vs. Pre-operation baseline was evaluated on NYHA functional class (SMD -2.09, 95% CI -2.53 to -1.64, p=<0.001). His bundle pacing significantly improved NYHA functional class (SMD -2.09; 95% CI -2.53 to -1.64; p<0.001), increased LVEF, and reduced QRS duration.
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