Table 2

Permanent HBP Implant Characteristics

First Author, Year (Ref. #)PatientsAV Nodal Block (Success %)Infranodal BlockLead TypeDelivery SheathBackup RV LeadFluoroscopy Times (Procedure)Pacing Threshold (Implant)Lead FailureClinical Outcomes
Deshmukh et al. 2000 (26) (N = 18)Chronic AF, AV node ablation, DCM12 of 18 (66%)0Stylet-driven0Yes3.5 ± 1.5 h (P)DHBP: 2.4 ± 0.9 V at 0.5 ms2 of 12Improved LVEF, decreased LV dimension, improved NYHA functional class
Occhetta et al., 2006 (27) (N = 18)Chronic AF, AV node ablation16 of 18 (89%)
DHBP: 25% PHP: 75%
0Stylet-driven01618 ± 9 min (F)DHBP: 3.7 V at 0.5 ms
PHP: 0.9 ± 0.7 V at 0.5 ms
1 of 16Improved NYHA functional class, QOL, 6-min walk, electromechanical delay compared with RVA pacing
Occhetta et al., 2007 (28) (N = 68)AF, AV node ablation (n = 52)
AV block (n = 16)
63 of 68
DHBP: 21%
PHP: 79%
0Stylet-38 SS 25C3041715 ± 8 min (F)DHBP: 3.7 V
PHP: 0.6 ± 0.3 V at 0.5 ms
3 of 68Improved NYHA functional class, QOL, 6-min walk
Barba-Pichardo 2010 (29) (N = 182)HBP attempted in 91 (AVB with HB recruitment with temporary pacing)44 of 65 (68%)15 of 26 (57%)Stylet-driven015NANodal: 1.4 ± 0.6 V at 1 ms
Infranodal: 1.9 ± 1.2 V at 1 ms
3 of 59
Kronborg et al., 2014 (30) (N = 38)AV node block
QRS duration <120 ms
LVEF >40%
Crossover, randomized
32 of 36 (85%)
DHBP: 4
PHP: 28
0SSC3043223 ± 13 min (F)
85 ± 31 min (P)
DHBP: 2.3 ± 1 V at 0.5 ms
PHP: 1.7 ± 1.5 V at 0.5 ms
3 of 32LVEF 55% vs. 50% with RVSP (p = 0.005) at 1 yr
Zanon et al., 2011 (31) (N = 307)SSS: 126
AVB: 181
95%
DHBP: 28%
PHP: 72%
0SSC304126 of 307
41%
S: 15 ± 9 min
NS: 18 ± 13 min
DHBP: 2.5 ± 2.3 V at 0.5 ms
PHP: 1.3 ± 1.3 V at 0.5 ms
4%
Vijayaraman et al., 2015 (32) (N = 67)SSS: 40%, AVB: 60%
HB IC positive: 37%
HB IC negative: 63%
60 of 67 (90%)
S-HBP: 45%
NS-HBP: 55%
SSC315His0IC+ 8.9 ± 4.0 m (F)
64 ± 10 m (P)
IC− 9.5 ± 3.0 m (F)
67 ± 13 m (P)
1.16 ± 0.40 V at 0.5 ms
1.75 ± 0.70 V at 0.5 ms
1HB IC associated with significantly lower pacing thresholds (p < 0.05)
Sharma et al., 2015 (33) (N = 95)SSS: 41%
AVB: 59%
75 of 95 (80%)
S-HBP: 45%
NS-HBP: 55%
21 of 26SSC315HIs012 ± 8 min (F)
79 ± 25 min (P)
1.35 ± 0.9 V at 0.5 ms3%Improved HF hospitalizations compared with RVP (2% vs. 15%; p = 0.02)
No difference in mortality (13% vs. 18%; p = 0.45)
Vijayaraman et al., 2015 (34) (N = 100)Advanced AVB
AVN: 46, infranodal: 54
43 of 46 (93%)
S-HBP: 44%
NS-HBP: 56%
41 of 54 (76%)
S-HBP 7%
SSC315HisBVP 611 ± 6 min (F)
71 ± 21 min (P)
1.4 ± 1.0 V at 0.5 ms5%

AVB = atrioventricular block; DCM = dilated cardiomyopathy; DHBP = direct His-bundle pacing; F = fluoroscopy duration; HB IC = His-bundle injury current; HBP = His-bundle pacing; HR = hazard ratio; NS = nonselective; P = procedure duration; PHP = para-Hisian pacing; RVSP = right ventricular septal pacing; S = selective; SS = SelectSecure; SSS = sick sinus syndrome; other abbreviations as in Table 1.