Intermediate Term Performance and Safety of His Bundle Pacing Leads: A Single Center Experience

Abstract Background The short-term safety, feasibility, and performance of the His bundle pacing (HBP) leads have been reported, however, their longer-term performance beyond 1 year remains unclear. Objective The objective of this study was to examine the intermediate-term performance and safety of HBP. Methods All HBP lead implants at Virginia Commonwealth University between 01-2014 and 01-2019 were analyzed. HBP was performed using a SelectSecureTM 3830-69 cm pacing lead (Medtronic, Minneapolis, MN). Results Of 295 attempts, successful HBP implantation (selective or non-selective) was seen in 274 (93%) cases. The mean follow-up duration was 22.8±19.5 months (median 19.5 months, IQR 11-33 months). Mean age was 69±15 years, 58% were males, and ejection fraction Conclusion While HBP can prevent or improve pacing induced cardiomyopathy, the elevated capture thresholds, loss of His bundle capture, and lead revision rates at intermediate follow-up are concerning. Longer-term follow-up data from multiple centers are needed.