ObjectivesTo systematically review the efficacy of high-intensity intermittent exercise (HIIE) on cardiac function, exercise capacity, quality of life and depression in patients with heart failure.MethodsPubMed, Web of Science, The Cochrane Library, EBSCOhost, EMbase, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on HIIE on cardiac function, exercise capacity, quality of life and depression in patients with heart failure from inception to April, 2019. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, RevMan 5.3 software and Stata 15.1 software were used for meta-analysis.ResultsA total of 16 RCTs involving 549 patients were included. The results of meta-analysis showed that, compared with the control group, HIIE could increase peak oxygen consumption (MD=2.04, 95%CI 0.74 to 3.33, P=0.002), peak work rate (MD=12.85, 95%CI 1.17 to 24.52, P=0.03), left ventricular ejection fraction (MD=4.24, 95% CI 1.40 to 7.07, P=0.003), quality of life (MD=7.32, 95%CI 1.41 to 13.22, P=0.02), and the six minute walk distance (MD=42.46, 95%CI 20.40 to 64.52, P=0.000 2). However, there was no significant difference between two groups in the depression score (SMD=0.39, 95%CI −0.52 to 1.31, P=0.40) and VE/VCO2 Slope (MD=0.12, 95%CI −1.02 to 1.26, P=0.84).ConclusionsCurrent evidence shows that compared with routine exercise or moderate intensity exercise, HIIE can improve exercise capacity, quality of life and cardiac function in patients with heart failure, but there is no significant difference in improving depression. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.