Permanent His Bundle Pacing in atrioventricular block patients：A
systematic review and meta-analysis
【Abstract】 Background:Cardiac pacemakers are still an effective
method for the treatment of atrioventricular block diseases(AVB).
Ventricular pacing results in adverse clinical outcome. For patients
with atrioventricular conduction system disease, minimization
ventricular pacing not be used to reduce the proportion of ventricular
pacing and improve cardiac function. Recent studies have shown that His
bundle pacing(HBP) can be an effective treatment for patients with
atrioventricular block . The purpose of this study was to evaluate the
effectiveness of His bundle in patients with AVB. Methods:We searched
the studies from Pubmed,Embase and Cochrane Library database to evaluate
the application of HBP in patients with AVB. From these studies, we
extrated and summarized the related data such as implantation success
rate, QRS width, pacing threshold at baseline and follow-up, assessment
left ventricular function, complications. Results:This Meta- analysis
included eight studies, including 430 patients. The success rate of
implantation varied from 65% to 93%. The main indications of HBP were
patients with AVB, including patients with atrioventricular node block
and intranodal block. Left ventricular function(left ventricular
ejection fraction) was not significantly improved during follow-up. The
duration of QRS after HBP implantation was more narrow (113±18ms).
Compared with the baseline level, the threshold of HBP was not
significantly increased during follow-up. During an average of 12 months
of follow-up, pacemaker-related complications occurred in 16 patients.
Conclusion:Permanent HBP has shown promising results for patients with
AVB in small observational studies. Randomized controlled trials are
needed to assess the efficacy of HBP in these patients.