His-bundle pacing
A physiologic pacing technique that directly stimulates the heart's natural conduction system at the His bundle.
Full Definition
His-bundle pacing is an advanced pacing strategy that places the pacing lead at the His bundle location to directly stimulate the heart's intrinsic conduction system. This technique preserves normal ventricular activation patterns, avoiding the dyssynchrony associated with conventional right ventricular pacing. The procedure requires specialized mapping techniques and fluoroscopic guidance to identify the optimal His bundle location. His-bundle pacing can maintain normal QRS duration and improve hemodynamics compared to conventional pacing, but technical challenges include higher capture thresholds, potential need for backup pacing, and procedural complexity. Success rates and lead longevity continue to improve with advancing techniques and lead technology.
Usage
Usage note: Specify whether selective or non-selective His capture is achieved in technical documentation.
In Context
- "His-bundle pacing was attempted but backup right ventricular pacing was required due to high thresholds." — Procedural report
- "The patient's QRS duration remained normal with successful His-bundle pacing capture." — Follow-up assessment