Comparing His-bundle pacing and Right Ventricular Apical Pacing for Heart Failure

His-bundle Pacing vs. Right Ventricular Apical Pacing in Patients With Reduced Ejection

Not applicable Interventional Region Skane · NCT04529577

This study is testing if a new type of heart pacing called His-bundle pacing works better than the standard right ventricular apical pacing for people with heart failure and a specific heart block who need a pacemaker.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment40 (estimated)
Ages18 Years to 100 Years
SexAll
SponsorRegion Skane Academic / other
Locations3 sites (Lund and 2 other locations)
Trial IDNCT04529577 on ClinicalTrials.gov

What this trial studies

This study compares the effectiveness of His-bundle pacing versus standard right ventricular apical pacing in patients with reduced ejection fraction and atrioventricular block requiring pacemaker therapy. It employs a randomized double-blinded crossover design, where patients receive both pacing modalities over a 6-month period, allowing for direct comparison of outcomes. The primary outcome measured is the change in left ventricular ejection fraction, while secondary outcomes include device safety and quality of life assessments. Patients are closely monitored, and both the patients and endpoint adjudicators remain blinded to the pacing modality during the study.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with high-degree AV block and a left ventricular ejection fraction between 40% and 55%.

Not a fit: Patients with conditions such as hypertrophic cardiomyopathy, cardiac sarcoidosis, or those who have had a recent myocardial infarction may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could improve heart function and quality of life for patients with heart failure requiring pacing.

How similar studies have performed: Other studies have shown promising results with His-bundle pacing, indicating potential benefits over traditional pacing methods.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* AV block II or III with high expected pacing need
* Left ventricular ejection fraction between 40% and 55% (inclusive)
* Willing to participate and sign informed consent

Exclusion Criteria:

* Under 18 years old
* Pregnant
* Hypertrophic cardiomyopathy
* Cardiac sarcoidosis
* Cardiac amyloidosis
* Previous myocardial infarction within last 3 months
* Ventricular septum defect or other other left ventricular corrective surgery
* Congenital heart disease surgically corrected
* Atrial fibrillation with uncontrolled rate (if not planned for AV node ablation)

Where this trial is running

Lund and 2 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions His Bundle PacingHeart Failure, SystolicHis bundle pacingConduction system pacingHeart failure, systolicQuality of lifeLeft ventricular ejection fraction
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.