Current Heart Failure Reports

, Volume 16, Issue 1, pp 47–56 | Cite as

His Bundle Pacing in Heart Failure—Concept and Current Data

  • Philip L. Mar
  • Subodh R. Devabhaktuni
  • Gopi DandamudiEmail author
Devices (C Veltmann, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Devices


Purpose of Review

His bundle pacing (HBP) has continued to emerge as a viable alternative to both right ventricular pacing (RVP) and cardiac resynchronization therapy. In recent years, a considerable amount of research has been published with regard to using HBP to treat congestive heart failure (CHF) and this article presents a concise yet comprehensive review of this literature.

Recent Findings

Studies have demonstrated that HBP is useful for CHF patients who are non-responders to biventricular pacing (BiVP) or have a history of previously failed coronary sinus lead placement, right/left bundle branch block cardiomyopathy, or pacing-induced cardiomyopathy. Additionally, HBP is useful in patients with an indication for pacing who are expected to have a RVP burden exceeding 20%.


The theoretical benefit of utilizing the native His Purkinje system to excite cardiac tissue is appealing as it can result in true cardiac resynchronization. Limited studies have shown its benefit in reducing heart failure symptoms and improving cardiac function. Larger randomized clinical trials and further investments into developing better technologies are highly desired to make its clinical use sustainable in the long run.


His bundle pacing Cardiac resynchronization therapy Heart failure Cardiac dyssynchrony Pacing-induced cardiomyopathy 


Compliance with Ethical Standards

Conflict of Interest

Philip L Mar and Subodh R Devabhaktuni each declare no potential conflicts of interest. Gopi Dandamudi is a consultant and on the advisory board for Medtronic, Inc. and on the advisory board for Biotronik, Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Philip L. Mar
    • 1
  • Subodh R. Devabhaktuni
    • 1
  • Gopi Dandamudi
    • 1
    • 2
    Email author
  1. 1.Indiana UniversityIndianapolisUSA

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