His-bundle pacing
Physiologic pacing technique targeting the His bundle to preserve normal ventricular activation patterns.
Full Definition
A specialized pacing technique that directly stimulates the His bundle to preserve the normal sequence of ventricular activation through the native conduction system. His-bundle pacing maintains physiologic electrical and mechanical synchrony, avoiding the detrimental effects of right ventricular pacing-induced dyssynchrony. The technique requires precise lead positioning guided by electrograms showing His bundle potentials and may involve selective or non-selective capture depending on output settings. Clinical applications include atrioventricular block, heart failure patients requiring chronic pacing, and as an alternative to cardiac resynchronization therapy. Success rates and long-term stability vary based on anatomic factors and capture thresholds.
Usage
Usage note: Distinguish between selective and non-selective His-bundle capture in documentation.
In Context
- "His-bundle pacing achieved selective capture with narrow QRS morphology at 1.5V threshold." — Physiologic pacing implant note
- "The patient demonstrated excellent QRS synchrony with His-bundle pacing compared to conventional RV pacing." — Conduction system pacing follow-up