Q: Is this procedure covered by most insurance policies?
A: Yes, alternate site pacing has been supported by insurance companies for quite some time.
Q: Why have so many doctors changed from “conventional” pacing to His bundle pacing?
A: Scientific patient studies from 2000 to present have concluded that apical (conventional) pacing results in heart failure in 10% to 13% of patients within a few months, increasing even further over time. This applies to patients, experiencing ventricular pacing, 20% of the time or more. There is also the increased risk of atrial fibrillation. Your heart doctor is aware of this, and may have warned you.
Q: Why is the His bundle so important?
A: The literature suggests that the heart remodels in response to the artificial pattern of heart muscle contraction produced by conventional pacing. This results in dystrophic calcification throughout the heart, mitochondrial abnormalities in cells away from the pacing electrode, endothelial dysfunction, increased sympathetic tone, hypertrophy away from the electrode site, compromised cardiac perfusion, and myofibrillar disarray.
Q: What is the His pacing clinical outcome vs. conventional pacing?
A: “…heart failure hospitalization was significantly reduced in the HBP (His bundle paced) group than in the RVP (right ventricular paced) group (2% vs 15%; P=.02).” See: Permanent His-bundle Pacing is Feasible, Safe, and Superior to Right Ventricular Pacing in Routine Clinical Practice
Q: How might I find physicians who are familiar with this procedure and are able to recommend it to my own physician?
A: E-mail us and let us know where you are and we will see who does His pacing nearest you.
Q: How might I become involved in advocacy for His bundle pacing?
A: Write to us and let us know of your interest, or leave us a note on our “Contact Us” page.
For physicians…
Q: Does it take more time to place the pacemaker at the His bundle?
A: Naperkowskie, et al. found that “Fluoroscopy and procedure duration was comparable to conventional pacing” using a catheter introduced lead. (Direct Implantation of Permanent His Bundle Pacing Lead in Patients with Complete Heart Block Without a Mapping Catheter or a Back-up Right Ventricular Lead: Feasibility and One year Follow-up, Heart Rhythm Society, Scientific Sessions, 2013.)
Q: Is the His pacing voltage threshold really lower than it is for the left-heart lead threshold for CRT?
A: Yes, see: Permanent His-bundle Pacing is Feasible, Safe, and Superior to Right Ventricular Pacing in Routine Clinical Practice compared to Safety of Transvenous Cardiac Resynchronization System Implantation in Patients With Chronic Heart Failure.