As an alternative to antiarrhythmic drugs and catheter ablation of atrial fibrillation (AF) for rate and rhythm control, pacing combined with atrioventricular node (AVN) ablation is suitable for many AF patients with heart failure (HF) who suffer from symptoms despite optimal medical therapy or have failed AF ablation. Studies have demonstrated His bundle pacing in conjunction with AVN ablation to treat refractory AF patients with HF provide long-term clinical benefits. Here we introduce the clinical application and procedures of His bundle pacing and AVN ablation.