Permanent His bundle pacing in heart failure patients: A systematic review and meta‐analysis

Background Cardiac resynchronization therapy (CRT) is the standard‐of‐care therapy for the patients with heart failure and left ventricular (LV) dyssynchrony. However, approximately 30% of the patients show no response. Recent studies have shown that His bundle pacing (HBP) could be an alternative for the patients with CRT indications. The purpose of this study was to evaluate the efficacy of HBP in patients with heart failure. Methods We searched PubMed and Embase databases for studies evaluating HBP in patients with heart failure and LV dyssynchrony. The successful rate of implantation, QRS duration, pacing threshold, LV function at baseline and follow‐up, and mortality rates were extracted and summarized. Results Eleven studies including 494 patients were included in this analysis. The overall successful rate for implantation was 82.4%. The main indications for HBP were CRT candidates and cardiomyopathy with atrial fibrillation undergoing atrioventricular node ablation. Permanent HBP resulted in narrow QRS duration of 116.3 ± 13.9 ms after implantation. LV functions, including echocardiographic parameters and clinical outcomes, significantly improved at follow‐up (P