Permanent His Bundle Pacing in Patients With Congenital Complete Heart Block: A Multicenter Experience

Gopi Dandamudi, Joel Simon, Oscar Cano, Vivak Master, Jacob S. Koruth, Angela Naperkowski, Adam C. Kean, Robert Schaller, Kenneth A. Ellenbogen, Jordana Kron, Pugazhendhi Vijayaraman

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objectives: This study retrospectively assessed the safety and efficacy of permanent His bundle pacing (HBP) in patients with congenital complete heart block (CCHB). Background: HBP has become an accepted form of pacing in adults. Its role in CCHB is not known. Methods: Seventeen patients with CCHB who underwent successful HBP were analyzed at 6 academic centers between 2016 and 2019. Nine patients had de novo implants, and 8 patients had previous right ventricular (RV) leads. Three RV paced patients had reduced left ventricular ejection fractions at the time of HBP. Implant/follow-up device parameters, New York Heart Association functional class, QRS duration, and left ventricular ejection fraction data were analyzed. Results: Patients’ mean age was 27.4 ± 11.3 years, 59% were women, and mean follow-up was 385 ± 279 days. The following parameters were found to be statistically significant between implant and follow-up, respectively: impedance, 602 ± 173 Ω versus 460 ± 80 Ω (p < 0.001); and New York Heart Association functional class, 1.7 ± 0.9 versus 1.1 ± 0.3 (p = 0.014). In patients with previous RV pacing, HBP resulted in a significant decrease in QRS duration: 167.1 ± 14.3 ms versus 118.3 ± 13.9 ms (p < 0.0001). In de novo implants, HBP resulted in increases in QRS duration compared with baseline: 111.1 ± 19.4 ms versus 91.0 ± 4.8 ms (p = 0.016). Other parameters exhibited no statistically significant differences. During follow-up, 2 patients required lead revision due to elevated pacing thresholds. Conclusions: HBP seems to be safe and effective, with improvement in clinical outcomes in patients with CCHB. Larger studies with longer follow-up periods are required to confirm our findings.

Original languageEnglish
Pages (from-to)522-529
Number of pages8
JournalJACC: Clinical Electrophysiology
Issue number4
StatePublished - Apr 2021


  • His bundle pacing
  • congenital complete heart block
  • pacing-induced cardiomyopathy


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