Shun Takeuchi, Rie Aoyama, Takashi Uchiyama, Tomohiko Hayashi, Shinichi Okino, Shigeru Fukuzawa
Background: His bundle pacing (HBP) preserves physiological pacing in atrioventricular block (AVB) but may have unstable thresholds. We evaluated practical septal pacing (PSP) for AVB. Methods and Results: We studied 92 AVB patients (41 HBP, 51 PSP). PSP was finalized at the narrowest attainable pQRSd with acceptable pacing parameters. Implant pQRSd was similar, while PSP had lower thresholds (0.5 vs. 1.0V; P<0.01) and remained lower at 18 months; thresholds ≥2.5V occurred less often (2% vs. 27%). No septal perforation occurred, and 1-year survival and heart failure hospitalization were comparable. Conclusions: PSP may offer a simple method with stable thresholds.