His Bundle Pacing hiting mainstream

I have posted before about receiving a Bundle of His pacing (HBP).It has been 3 1/2 years now and my LBBB is still corrected and the RVlead threshold has not increased and I have had no major problems.

At the time I got my PM there was little talk about HBP now there are articles almost everywhere and my EP doc was one of the few doing that technique.

Here is a link about developments in HBP from a EP doc who has been converted to a HBP enthusiast.https://www.medscape.com/viewarticle/879996#vp_2

I would like to hear if there are others in the club who have His Bundle Pacing.




HIS Bundle Pacing

by lefty2 - 2019-03-15 14:51:17


I have a CRT-D and they are having trouble placing the 3rd wire. I have a choice of either having it done via surgery or considering a HIS Bundle pacing wire.

Just curious if your EF has increased with the procedure?

His Bundle Pacing

by fox30 - 2019-03-15 17:49:49

Yes My EF did increase after HBP.

Actually my EF, pre PM insertion, was at the lower limits of normal. I was not in overt HF. I got the PM because I had Second degree Heart block that was exercise induced The EP doc implanted a LV lead AND a His BUndle lead.I have not needed the LV Lead which would have been part of BiV pacing.This  was in 2015 and the EP doc was just beginning to do do HBP and considered  the LV lead as back-up since at implantation he was able to correct the LBBB pattern with a normal qrs complex.

On the operative note the EP doc described the situation as the patient having "mildly decreased left ventricualr function". 

The pre implant echo was read as "lower limits normal LV functionl.Estimated EF 50-54."

6 weeks later echo read as "LV function is normal .Estimated EF 55-5 9%.

Significantly 3 mos. later I was once again again to run at about the same pace as before I developed the LBBB.

Several review articles have indicated that HBP is at least as effective as Bi V pacing for CRT.

There is a learning curve with HB pacing and ideally someone would want their doctor to have had sufficient experience with the procedure for him to be confident.

I hope what ever version of CRT you get works well for you. 








by Newbie4444 - 2019-03-15 20:38:28

I just got mine placed last Friday at University of Pennsylvania hospital. I didn’t even known His Bundle pacing was a thing. When I came out of surgery, the doc gave me a science lesson and showed me that they had placed the 2nd lead in the bundle of His. He said it’s been done this way for the past 3-4 years and shows a much lower risk of congestive heart failure long term. 

Who was your Doctor?

by lefty2 - 2019-03-17 11:50:38

I am seen by a cardiologist at a NYC hosptial and they do not seem to have anyone who has done many HIS bundle pacing procedure. From what I have read, you should see one who has done many procedures.

Who do you recommend?


His Bundle Pacing

by fox30 - 2019-03-17 15:16:41

Many centers in the country are doing HB pacing now. Some of them are

Geisinger Clinic in Pennsylvania,University of Chicago, University of Vermont,Virginia Commonwealth Medical School,UCLA,Debakey Cardiology Group at Houston Methodist Hospital, Rush Medical Center, Indian University School of Medicine,Cleveland CLinic, and  Dr. John Mandrola in Kentucky to name a few. 

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