Ask an Expert

Please enter your login and password here



Please enter your login and password here


Journal Scan

Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice.

Heart Rhythm. 2015 Feb;12(2):305-12.

Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice.

Sharma PS1Dandamudi G1Naperkowski A1Oren JW2Storm RH2Ellenbogen KA3Vijayaraman P4.


Right ventricular pacing (RVP) has been associated with heart failure and increased mortality. His-bundle pacing (HBP) is more physiological but requires a mapping catheter or a backup right ventricular lead and is technically challenging.


We sought to assess the feasibility, safety, and clinical outcomes of permanent HBP in an unselected population as compared to RVP.


All patients requiring pacemaker implantation routinely underwent attempt at permanent HBP using the Select Secure (model 3830) pacing lead in the year 2011 delivered through a fixed-shaped catheter (C315 HIS) at one hospital and RVP at the second hospital. Patients were followed from implantation, 2 weeks, 2 months, 1 year, and 2 years. Fluoroscopy time (FT), pacing threshold (PTh), complications, heart failure hospitalization, and mortality were compared.


HBP was attempted in 94 consecutive patients, while 98 patients underwent RVP. HBP was successful in 75 patients (80%). FT was similar (12.7 ± 8 minutes vs 10 ± 14 minutes; median 9.1 vs 6.4 minutes; P = .14) and PTh was higher in the HBP group than in the RVP group (1.35 ± 0.9 V vs 0.6 ± 0.5 V at 0.5 ms; P < .001) and remained stable over a 2-year follow-up period. In patients with >40% ventricular pacing (>60% of patients), heart failure hospitalization was significantly reduced in the HBP group than in the RVP group (2% vs 15%; P = .02). There was no difference in mortality between the 2 groups (13% in the HBP group vs 18% in the RVP group; P = .45).


Permanent HBP without a mapping catheter or a backup right ventricular lead was successfully achieved in 80% of patients. PTh was higher and FT was comparable to those of the RVP group. Clinical outcomes were better in the HBP group than in the RVP group.



  • Members - Full time life members with voting rights: All those with DM/DNB cardiology qualification or equivalent and interest in arrhythmia/EP : Fees Rs 10,000.
  • Associate Members - DM/DNB/Fellows during training period. Fees Rs 3,000. No voting rights.
  • International Members: Overseas doctors with appropriate qualification and interest in arrhythmias. No voting rights. Fees 300$.
  • Industry members: Industry personnel associated with arrhythmology can become members. Membership is non-transferable. No voting rights. Fees 25,0000.
  • Any Associate Members who become eligible for Full time life membership (on completion of training period), need to pay only the balance of Rs 7,000 (10,000 - 3,000) if this is one within 1 year after completion of training. If the application for Full time life membership is received after expiry of one year of their entry as Associate Members, the full fees (viz Rs 10,000) shall apply.
  • Membership application need to be endorsed by two IHRS Members.
  • The application forms received by the office of Secretary, IHRS would need to be finally approved by the credentialing Committee (comprising of President, Secretary and Joint Secretary, IHRS).

Please print this form and send appropriate DD/Cheque in favour of Indian Heart Rhythm Society, and send through post to the following Address:

Dr Anil Saxena
Director, Cardiac Pacing & Electrophysiology
Fortis Escorts Heart Institute
Okhla Road, New Delhi, 110025 INDIA
Secretary, Indian Heart Rhythm Society
Mobile: +91 9810025511
Secretary: +91 9910665566 (Ms Kumkum Sharma)