HIS Bundle Pacing

HIS Bundle Pacing

HIS Bundle Pacing


HIS Bundle Pacing stands as an innovative and advanced cardiac pacing technique designed to address specific cardiac rhythm disorders. It involves the precise placement of a pacing lead on the HIS bundle, a critical part of the heart's intricate electrical conduction system. This method is gaining prominence for its potential to restore normal heart rhythm more physiologically and efficiently compared to traditional pacing options.


The HIS Bundle Pacing procedure is a specialized intervention performed in an electrophysiology lab, where the focus is on mapping and understanding the heart's electrical pathways. Here's a step-by-step breakdown of the procedure:

1. Preparation: Patients undergoing HIS Bundle Pacing are generally awake but sedated to ensure comfort. The initial step involves cleaning and numbing the area, typically near the collarbone, where the pacing lead will be inserted.

2. Lead Placement: Utilizing fluoroscopy and advanced mapping techniques, the medical team guides a thin lead wire through the veins, positioning it precisely on the HIS bundle. This requires a high level of expertise and precision.

3. Testing and Adjustment: After lead placement, the medical team conducts tests to ensure optimal positioning and makes necessary adjustments to achieve the desired pacing parameters. This phase is crucial in determining the success of the procedure.

4. Device Implantation: Once the medical team is satisfied with lead placement, the pacing lead is connected to a pacemaker or implantable cardioverter-defibrillator (ICD) device. This device is then implanted under the skin, typically in the chest region.

How to Prepare for the Test

Proper preparation is essential to ensure the success and safety of the HIS Bundle Pacing procedure. Patients are usually given specific instructions by their healthcare providers, including:

·         Fasting: In some cases, patients may be required to fast for a certain period before the procedure to minimize potential complications.

·         Medication Adjustments: The medical team will provide detailed instructions regarding any medications that need to be adjusted or temporarily stopped before the test. This step is critical in preventing interference with the procedure.

Adhering to these preparation guidelines is crucial for a smooth and successful HIS Bundle Pacing procedure.

How the Test Will Feel

During the procedure, patients are typically under sedation, ensuring minimal discomfort. While some individuals may experience a mild sensation as the pacing lead is being positioned, this discomfort is generally well-tolerated. The goal is to make the patient as comfortable as possible throughout the procedure.

Why the Test is Performed

HIS Bundle Pacing is recommended for individuals with specific heart rhythm disorders or those who have not responded adequately to traditional pacing methods. The primary objective of the procedure is to restore a more natural and efficient heart conduction system. The benefits may include improved symptoms and overall cardiac function.


Following the HIS Bundle Pacing procedure, patients enter a monitoring phase to assess the effectiveness of the pacing and ensure optimal heart function. Results can vary among individuals, and specific outcomes and expectations are discussed during follow-up appointments with the healthcare provider.


While HIS Bundle Pacing is generally considered safe, like any medical procedure, it is not without risks. Some potential risks include:

·         Bleeding or Infection: There is a slight risk of bleeding or infection at the site where the pacing lead is inserted. Close monitoring and proper care can mitigate these risks.

·         Pacing Lead Displacement: In rare cases, the pacing lead may need repositioning due to displacement. Regular follow-up appointments are crucial to detect and address such issues promptly.

·         Allergic Reaction: Some patients may experience an allergic reaction to the materials used during the procedure. This risk is usually minimized through thorough pre-procedure assessments.

Patients must engage in open and thorough discussions with their healthcare providers to understand the potential risks and benefits associated with HIS Bundle Pacing fully.