29Dec 2022
Effects of haemodynamically atrio‐ventricular optimized His‐pacing on heart failure symptoms and exercise capacity: The His Optimized Pacing Evaluated for Heart Failure (HOPE‐HF) randomised, double‐blind, cross‐over trial

Effects of haemodynamically atrio‐ventricular optimized His‐pacing on heart failure symptoms and exercise capacity: The His Optimized Pacing Evaluated for Heart Failure (HOPE‐HF) randomised, double‐blind, cross‐over trial

Excessive prolongation of PR interval impairs the coupling of AV contraction, which reduces left ventricular pre‐load and stroke volume, and worsens symptoms. His‐bundle pacing allows AV‐delay shortening while maintaining normal ventricular activation. HOPE‐HF evaluated whether AV‐optimized His pacing is preferable to no‐pacing, in double‐blind cross‐over fashion, in patients with heart failure, left ventricular ejection fraction (LVEF) ≤40%, PR interval ≥200ms and either QRS ≤140ms or right BBB.bHis‐bundle pacing did not increase peak oxygen uptake but, under double‐blind conditions, significantly improved quality of life and was symptomatically preferred by the clear majority of patients. In addition, ventricular pacing delivered via the His bundle did not adversely impact ventricular function during the six months.

  • #cardiology

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