Increased capture threshold in permanent His-bundle pacing associated with flecainide

Michael Jiang*, Jeremiah Wasserlauf, Bradley P. Knight, Nishant Verma

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


A 64-year-old man underwent implantation of a permanent His-bundle pacemaker. A marked rise in the selective His-bundle capture threshold was noted 1 month after the patient started flecainide acetate for rhythm control of recurrent, symptomatic atrial flutter and atrial fibrillation. The capture threshold subsequently normalized 4 days after discontinuing flecainide and switching to dofetilide. To our knowledge, this is the first documented case of a rise in selective His-bundle capture threshold associated with flecainide acetate. Further studies are needed to characterize this association which could result in higher capture thresholds, decreased battery longevity, and mimic His-bundle lead failure.

Original languageEnglish (US)
Pages (from-to)360-363
Number of pages4
JournalPACE - Pacing and Clinical Electrophysiology
Issue number4
StatePublished - Apr 1 2020


  • flecainide acetate
  • pacemaker
  • pacing
  • permanent His-bundle pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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