BACKGROUND: High capture thresholds and lead dislodgment are often cited as impediments for general adoption of His bundle pacing. OBJECTIVE: We report on our experience in managing patients who underwent His bundle pacing with higher energy requirement and incidence of lead dislodgment in a mean duration of 33 months. METHODS: In 1188 patients, pacing was done at the site of His bundle electrogram and capture of conduction axis was confirmed by paced complex demonstrating normal or more normal QRS voltage, QRS axis, and ventricular activation time. Patients were followed for 33 months with routine programming changes to optimize battery longevity. RESULTS: His bundle pacing thresholds revealed a small but significant increase in His bundle capture (from 1.1 ± 0.8 to 1.3 ± 0.8 [P 2 V threshold in 16% of patients and the need for higher output pacemaker batteries.