Right ventricular apex pacing can have deleterious effects. Our aims were to investigate how many patients referred for permanent pacing were suitable candidates for permanent His bundle pacing, and to determine the proportion in whom such pacing was successful. All cases of suprahisian block and most cases of infrahisian block (71.4%) were corrected by temporary His bundle pacing. However, permanent His bundle pacing was achieved in only 55% of cases in which it was attempted, and in only 35.4% of all possible cases.