Introduction
His bundle pacing (HBP) recruits the native His Purkinje system by
transmitting the electrical pacing impulse directly to the electrical
conduction system of the heart. As such, HBP provides physiologic pacing
by avoiding ventricular dyssynchrony as is typically seen with right
ventricular (RV) pacing.1-3 HBP requires correct
placement of the pacing lead onto the His bundle. The anatomy of the His
bundle, its course along the ventricular septum and the amount of
adjacent myocardium vary among patients4 and may
contribute to different electrophysiological pacing responses. Safety
issues on HBP mostly considered stability of pacing thresholds and the
need for lead revisions.5, 6 However, there are no
reports on how HBP may affect the integrity of the ventricular septum.