Successful resynchronization by permanent His-bundle pacing in a patient with pacing-induced cardiomyopathy.

Right ventricular (RV) pacing has been reported to result in ventricular dyssynchrony, heart failure, and increased mortality. Pacing associated deterioration of left ventricular (LV) systolic function has been termed pacing-induced cardiomyopathy (PICM). While upgrading to biventricular pacing (BiVP) is an effective therapy for PICM, permanent His-bundle pacing (HBP) can be a physiological alternative to BiVP. We present a patient with PICM who responded dramatically to permanent HBP.