Medical City Fort Worth November 27, 2017

Dr. Aleem Mughal and the Medical City Fort Worth electrophysiology team.

An innovative heart pacemaker procedure called His-bundle pacing, performed for the first time in Tarrant County at Medical City Fort Worth, can help a patient’s heart beat more efficiently with the pacemaker, reducing the risk of congestive heart failure over time.

“His-bundle pacing could represent a paradigm shift in cardiac pacing,” says Medical City Fort Worth electrophysiologist Aleem I. Mughal, MD, who recently performed the His-bundle procedure for the first time in Tarrant County. “We can now produce a heartbeat for pacemaker patients that’s more efficient, more akin to the natural heartbeat, and with less hardware in the body.”

With a normal heartbeat, the right and left ventricles, or heart chambers, beat in unison. Standard pacemaker procedures activate the ventricles at different times, causing them to be out of synch and put patients at increased risk for congestive heart failure, fatigue, shortness of breath and life threatening arrhythmias, according to Dr. Mughal.

“The His-bundle procedure does not produce this synchronization problem,” Dr. Mughal adds. “His-bundle pacing mirrors a normal heartbeat. The right and left ventricles, or heart chambers, beat in unison and the heart works more efficiently with the ventricles in synch.”

Approximately 200,000 pacemakers are implanted each year in the United States, according to the American College of Cardiology. A pacemaker speeds up, or paces, a heartbeat that is too slow. Most pacemakers utilize two to three “leads” to conduct electrical current from the pacemaker into the heart. The His-bundle procedure uses just two leads and places one of them in a different location, the AV Node, which is more efficient at conducting electrical current to both ventricles, allowing them to beat in synchrony.

Knowledge of His-bundle pacing has been around for years, but the procedure was technically challenging. New equipment from Medtronic is making insertion of the pacemaker lead to the AV node much simpler.

For more information about heart and vascular services at Medical City Fort Worth, visit To find a physician, phone 855-807-5292.