Beneficial effects of upgrading to His bundle pacing in chronically paced patients with left ventricular ejection fraction <50%

Background Heart failure is common in patients with permanent pacemakers. Right ventricular (RV) pacing may worsen cardiac function, while the nonresponder rate of cardiac resynchronization therapy (CRT) for heart failure treatment remains 25%–30%. Objective The purpose of this study was to assess clinical outcomes of upgrading to permanent His bundle pacing (pHBP) in patients with heart failure who underwent device upgrade from right ventricular pacing or CRT nonresponse. Methods Eighteen patients with pacing-dependent heart failure and left ventricular ejection fraction (LVEF) Results Of the 16 patients (mean age 70.6 ± 12.9 years; 9 [56.3%] men), 11 (68.8%) patients had pacing-induced cardiomyopathy (PICM) while the remaining 5 (31.2%) patients were CRT nonresponders. After upgrading to pHBP, QRS duration was significantly shortened (from 156.9 ± 21.7 to 107.1 ± 16.5 ms; P P P P Conclusion In paced patients with clinically symptomatic heart failure and LVEF