Permanent direct His bundle pacing: initial report showing technical feasibility of an alternative pacing therapy.

To prevent deterioration of left ventricular function during right ventricular apical pacing, permanent direct His bundle stimulation can be considered in selected patients with low left ventricular ejection fraction and a normal His-ventricle conduction time. We describe our first short-term experiences with permanent direct His bundle pacing in three patients. In two patients His bundle stimulation was still effective at six weeks' follow-up. In one patient loss of capture was registered, after which conventional RV apical pacing was performed.