What does this research mean for the field?

Practical septal pacing provides a simplified strategy with more stable pacing thresholds compared to His bundle pacing for patients with atrioventricular block. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research aims to assess practical septal pacing for its efficacy and stability in atrioventricular block compared to traditional methods.

April 3, 2026Circulation Reports0 citationsOpen Access

Practical Septal Pacing for Atrioventricular Block　― A Simplified Septal Strategy With Stable Thresholds Compared With His Bundle Pacing ―

STShun Takeuchi RARie Aoyama TUTakashi Uchiyama

Key Points

The research aims to assess practical septal pacing for its efficacy and stability in atrioventricular block compared to traditional methods.
Evaluated practical septal pacing for atrioventricular block cases

Structured PICO

Does practical septal pacing improve capture thresholds and maintain narrow paced QRS duration compared to His bundle pacing in patients with atrioventricular block?

Population

92 consecutive patients with atrioventricular block (AVB) undergoing de novo pacemaker implantation.

Intervention

Practical septal pacing (PSP) (n=51), an ECG-guided septal implantation strategy prioritizing narrow paced QRS and stable pacing parameters.

Comparator

His bundle pacing (HBP) (n=41).

Outcome

Paced QRS duration (p-QRSd) and capture threshold at implantation and during follow up (1, 6, 12, and 18 months).surrogate

Practical septal pacing offers a simplified, ECG-guided alternative to His bundle pacing in AV block, achieving comparable QRS narrowing with significantly better threshold stability and fewer lead revisions.

Abstract

Background: His bundle pacing (HBP) preserves physiological pacing in atrioventricular block (AVB) but may have unstable thresholds. We evaluated practical septal pacing (PSP) for AVB.

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