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Related Experiment Video

Updated: Sep 13, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Battery longevity and His bundle lead performance in His bundle pacing.

Ayush Mohan1, Jenna Lee1, Whitney Adams1

  • 1McLaren Bay Heart and Vascular, McLaren Bay Region Hospital, Bay City, Michigan.

Heart Rhythm O2
|July 30, 2025
PubMed
Summary

His bundle pacing is viable long-term, with manageable capture thresholds and low lead dislodgment rates. Optimization of pulse duration and polarity is key for sustained His bundle pacing performance.

Keywords:
Fasiculo-ventricular pathwayHis bundle pacingLead performancePhysiological pacingSeptal pacing

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • High capture thresholds and lead dislodgment are significant barriers to widespread His bundle pacing adoption.
  • Understanding long-term performance is crucial for clinical implementation.

Purpose of the Study:

  • To evaluate the long-term outcomes of His bundle pacing, focusing on capture thresholds and lead dislodgment.
  • To assess the impact of programming adjustments on pacing parameters and battery longevity.

Main Methods:

  • A retrospective analysis of 1188 patients undergoing His bundle pacing.
  • Pacing at the His bundle electrogram site with confirmation of conduction axis capture.
  • Long-term follow-up (mean 33 months) including routine programming for battery optimization.

Main Results:

  • A small but significant increase in His bundle capture threshold was observed over time (1.1 to 1.3).
  • Optimized pulse duration and polarity maintained capture threshold energy, with an average predicted battery life of 8.5 years.
  • Lead dislodgment occurred in 1.2% of patients, and 16% had a threshold of ≥2 V at 33 months.

Conclusions:

  • His bundle pacing demonstrates manageable capture thresholds and acceptable lead dislodgment rates with optimized programming.
  • A notable percentage of patients require higher output pacemakers due to elevated thresholds.
  • Long-term His bundle pacing is feasible, but requires attention to capture thresholds and battery technology.