30
Implant Procedure
Table 3. Criteria for His Bundle Pacing
Baseline Normal QRS
Selective HBP S-QRS = H-QRS with isoelectric interval
Discrete local ventricular electrogram in HBP lead with S-V = H-V
Paced QRS = native QRS
Single capture threshold (His bundle)
Nonselective
HBP
S-QRS < H-QRS (usually 0, S-QRS
end
= H-QRS
end
) with or without
isoelectric interval (pseudodelta wave +/−)
Direct capture of local ventricular electrogram in HBP lead by stimulus
artifact (local myocardial capture)
Paced QRS > native QRS with normalization of precordial and limb
lead axes with respect to rapid dV/dt components of the QRS
2 distinct capture thresholds (His bundle capture, RV capture)
No QRS slur/notch in leads I, V1, or V4-V6, and V6 R-wave peak time
≤ 100 ms
Change in V6 RWPT > 12 ms between stimulus and His to V6 RWPT
confirms lack of His capture (99.1% sensitivity and 100% specificity)
Adapted with permission from Vijayaraman, et al. Heart Rhythm 2018;15:460-468
