Trial reportEuropean journal of heart failure2023
Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial.
Trial report in European journal of heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05491655 (High Intensity His Bundle Pacing in Heart Failure Patients With Narrow QRS Outcome Study), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
High Intensity His Bundle Pacing in Heart Failure Patients With Narrow QRS Outcome Study
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Conduction system pacing for cardiac resynchronization therapy: a systematic review.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Pooled it
- Conduction System Pacing Versus Biventricular Cardiac Resynchronization Pacing: Meta-Analysis on Outcomes in Patients with Non-Left Bundle Branch Block.Medicina (Kaunas, Lithuania) · 2025Pooled it
- A novel measure of AV-conduction predicts clinical outcomes and benefit from CRT-D in non-LBBB patients with wide QRS and a low left ventricular ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Trial
- Effectiveness of Bachmann's Bundle Pacing in a Patient With Severe Heart Failure and Refractory Atrial Fibrillation.Journal of arrhythmia · 2026Article
- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- Predictors of stroke volume improvement with AV-optimized conduction system pacing in patients with AV dromotropathy.ESC heart failure · 2026Article
- Physiologic Pacing in Heart Failure.The New England journal of medicine · 2026Review
- Painful left bundle branch block syndrome after interventional treatment of right coronary artery stenosis: a case report.Journal of cardiothoracic surgery · 2026Article
- High-Precision Hemodynamic and Echocardiographic Assessment of Pacing in Obstructive Hypertrophic Cardiomyopathy.Pacing and clinical electrophysiology : PACE · 2025Article
- Physiological pacing: mechanisms, clinical indications, and perspectives.European heart journal · 2025Review
- Article
- Apex vs. Septum Pacing: A Comprehensive Review of Pacemaker Implantation Strategies.Biomedicines · 2025Review
- A Meta-Analysis of Clinical and Echocardiographic Outcomes of Physiological Versus Conventional Pacing.Biomedicines · 2025Review
- European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- 2024 update in heart failure.ESC heart failure · 2025Review
- Pacing of the specialized His Purkinje conduction system: 'HOW and FOR WHOM'.European heart journal supplements : journal of the European Society of Cardiology · 2025Article
- Recent Advances in Cardiac Resynchronization Therapy: Current Treatment and Future Direction.Journal of clinical medicine · 2025Review
- Conduction System Pacing for CRT: A Physiological Alternative.Arrhythmia & electrophysiology review · 2025Review
- Optimizing outcomes from cardiac resynchronization therapy: what do recent data and insights say?Expert review of cardiovascular therapy · 2024Review
- Article
Corrections and comments
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Authors and funding
40 authors at 20 institutions in 2 countries.
Funding
Abstract
aimsExcessive prolongation of PR interval impairs coupling of atrio-ventricular (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 a double-blind cross-over fashion, in patients with heart failure, left ventricular ejection fraction (LVEF) ≤40%, PR interval ≥200 ms and either QRS ≤140 ms or right bundle branch block. METHODS AND
resultsPatients had atrial and His bundle leads implanted (and an implantable cardioverter-defibrillator lead if clinically indicated) and were randomized to 6 months of pacing and 6 months of no-pacing utilizing a cross-over design. The primary outcome was peak oxygen uptake during symptom-limited exercise. Quality of life, LVEF and patients' holistic symptomatic preference between arms were secondary outcomes. Overall, 167 patients were randomized: 90% men, 69 ± 10 years, QRS duration 124 ± 26 ms, PR interval 249 ± 59 ms, LVEF 33 ± 9%. Neither peak oxygen uptake (+0.25 ml/kg/min, 95% confidence interval [CI] -0.23 to +0.73, p = 0.3) nor LVEF (+0.5%, 95% CI -0.7 to 1.6, p = 0.4) changed with pacing but Minnesota Living with Heart Failure quality of life improved significantly (-3.7, 95% CI -7.1 to -0.3, p = 0.03). Seventy-six percent of patients preferred His bundle pacing-on and 24% pacing-off (p < 0.0001).
conclusionHis 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. Ventricular pacing delivered via the His bundle did not adversely impact ventricular function during the 6 months.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.