Abstract
Permanent unifocal right ventricular pacing can lead to ventricular dyssynchrony with subsequent dysfunction of the left ventricle, which can lead to heart failure. Heart failure caused by right ventricular pacing was traditionally associated with pacing from the apex of the right ventricle.
Over the last two decades, significant efforts have been made to find alternative pacing sites that can reduce or prevent the risk of heart failure. Based on the latest findings, pacing the His bundle area appears extremely promising.
In this case report, we present a 79-year-old male, who developed left ventricular dysfunction with heart failure within six months of right ventricular septal pacing. The patient was upgraded to CRT-D, and one of the pacing leads was implanted in the His bundle area.
Selective His bundle pacing led to normalization of QRS duration and a significant improvement of heart failure symptoms. Echocardiography performed after three months showed normalized left ventricular function.