His-bundle-pacing for patients requiring a permanent pacemaker or cardiac resynchronisation

Jeindl R, Wernly B
Record ID 32018002667
Authors' objectives: For patients with heart failure, cardiac conduction system disease (e.g. atrioventricular block), or atrial fibrillation, a pacemaker therapy may be indicated. In addition to established ventricular pacing systems, such as right ventricular or biventricular pacing, there is a new type of pacemakers called physiological pacing systems. Stimulation of the His bundle (His bundle pacing) can be classified as a physiological pacing system. His bundle pacing is intended to improve cardiac function and resynchronisation by stimulating only a single site.
Authors' results and conclusions: This evidence synthesis included four studies (4 RCTs and 1 cohort study). In the RCTs, a total of 163 patients were included, the cohort study included 765 patients. The study duration of the included studies ranged from six months to two years. The overall quality of the available evidence on effectiveness and safety was rated as very low (GRADE rating). For only one of the indications (heart failure), randomised trials were available. Compared with right ventricular pacing, there is evidence suggesting His bundle pacing may achieve better outcomes in certain conditions. In contrast, compared with biventricular pacing, the results were insufficient to demonstrate a benefit.
Authors' recommendations: Given the available evidence, results from ongoing studies should be awaited. The inclusion in the Austrian benefit catalogue is currently not recommended.
Project Status: Completed
Year Published: 2022
URL for additional information: https://eprints.aihta.at/1392
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Bundle of His
  • Pacemaker, Artificial
  • Cardiac Resynchronization Therapy
  • Cardiac Resynchronization Therapy Devices
  • Atrial Fibrillation
  • Heart Failure
  • Cardiac Conduction System Disease
  • Cardiac Pacing, Artificial
  • His-bundle-pacing
  • pacemaker
  • cardiac resynchronisation
  • cardiac conduction system
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Garnisongasse 7/20, A-1090 Vienna, Austria
Contact Name: office@aihta.at
Contact Email: office@aihta.at
Copyright: HTA Austria - AIHTA GmbH
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.