Objective:To investigate the long-term efficacy and safety of permanent His-bundle pacing(HBP).Methods:In a retrospective study,patients who underwent permanent pacemaker implantation at the Department of Cardiology,Second Affiliated Hospital of Xi'an Jiaotong University between August 2018 and December 2019 were enrolled.Among them,58 patients received His bundle pacing(HBP),while 66 patients received right ven-tricular septal pacing.The QRS durations and implantation success rate were observed.The threshold,imped-ance,R wave sensing,and related complications were monitored immediately post-implantation as well as at 1-year,2-year,and 3-year after operation.Results:Of 67 patients who planned to undergo HBP,58 were success-fully implanted(85.6％success rate).The preoperative QRS duration was 95.5±18.5 ms and postoperative QRS duration was 103.6±15.1 ms in the HBP group,with no statistical significance.In the right ventricular septal pacing group,the duration of QRS wave before operation was(101.8±26.9)ms,and the duration of QRS wave after operation was(145.2±11.8)ms(P＜0.05).The ventricular pacing thresholds were(0.83±0.43)V/0.4ms,(0.97±0.31)V/0.4ms,(1.11±0.39)V/0.4ms and(1.28±0.56)V/0.4ms in the HBP group immedi-ately and at 1,2 and 3 years after surgery,respectively,and the thresholds were increased year by year(P＜0.001).The threshold increased to 2.5V/1.0ms in 2 cases,and no loss occurred.One patient in HBP group de-veloped sac infection,and no other complications such as electrode dislocation and heart perforation occurred in both groups.Conclusion:HBP is considered the most physiological pacing mode,although it carries the potential risk of increasing in pacing threshold in long-term follow-up.
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