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Introduction: His bundle pacing (HBP) is more physiological compared to conventional pacing.This study assessed the effect of permanent HBP in patients who had heart failure with preserved and reduced left ventricular ejection fraction (HFpEF and HFrEF) and also underwent atrioventricular node (AVN) ablation for atrial fibrillation (AF).Methods: The study enrolled 42 patients (22 with HFpEF and 20 with HFrEF) who had persistent/chronic AF that caused frequent.hospitalizations for heart failure despite optimal pharmacological therapy.All patients underwent AVN ablation and permanent HBP.Patients were followed for a mean interval of 19 ± 9 months (median 18 months).Comparisons in echocardiographic left ventricular end-diastolic dimension (LVEDd) and left ventricular ejection fraction (LVEF),NYHA classification,and hospitalizations were made between the baseline and the last follow-up visit after permanent HBP.