Key result
An abrupt increase in His-bundle threshold and loss of capture occurred after 3.5 years of stable permanent His-bundle pacing, potentially due to local fibrosis and lead angle changes.
Why the study?
A His-bundle capture threshold rise remains a significant concern in permanent His-bundle pacing.
Case Report (n=1)
Highlights the risk of late, abrupt loss of capture in permanent His-bundle pacing due to local fibrosis and lead angle changes.
Late capture loss may occur in stable His-bundle pacing; leaves open incidence, mechanisms, and need for prospective monitoring studies.
A His-bundle (HB) capture threshold rise is still a significant concern in permanent His-bundle pacing (HBP). We present a case where an abrupt increase in HB threshold and loss of capture occurred even after 3.5 years of stable permanent HBP for an atrioventricular block. The development of local fibrosis around the lead helix and the change in an insertion angle of the lead might adversely affect the HB capture threshold in the chronic phase.
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Kato et al. (2024) conducted a case report in Atrioventricular block (n=1). Permanent His-bundle pacing was evaluated on Abrupt increase in His-bundle threshold and loss of capture. An abrupt increase in His-bundle threshold and loss of capture occurred after 3.5 years of stable permanent His-bundle pacing, potentially due to local fibrosis and lead angle changes.
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