Downside of His bundle pacing

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Downside of His bundle pacing

His bundle pacing is an option for physiological pacing compared to right ventricular pacing which can cause dyssynchrony with cardiac failure and atrial fibrillation in the long run. But there are some limitations for His bundle pacing:

  1. Difficulty in implantation
  2. Lower success rates in those with wide QRS
  3. High pacing threshold in some instances
  4. Unstable pacing thresholds in some


  1. Zhang S, Zhou X, Gold MR. Left Bundle Branch Pacing. J Am Coll Cardiol. 2019;74:3039-49,