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Para-Hisian Pacing: New Insights of an Old Pacing Maneuver (JACC: Clinical Electrophysiology November 2019)
More than two decades ago, para-Hisian pacing was introduced to assess the pattern of retrograde conduction during electrophysiological studies. Though there is no ideal maneuver for every patient and condition, para-Hisian pacing is a valuable and handy strategy to differentiate between retrograde conduction over the AV node and accessory pathways.

David J. Wilber, MD, FACC

CME Editor
Smit Vasaiwala, MD

Hussam Ali, MD, FESC, FEHRA
Riccardo Cappato, MD, FESC, FHRS

CME Information
Target Audience
JACC Journal CME is intended for physicians who treat patients with cardiovascular disease.

Important Dates
Date of Release: November 18, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: November 17, 2020

Learner Objectives
After reading this article the reader should be able to:
  • Identify the pattern of retrograde conduction through evaluation of the para-Hisian pacing (PHP) maneuver.
  • Discuss some pitfalls commonly encountered while interpreting the PHP maneuver.
  • Describe the main advantages and limitations of the PHP maneuver.
Method of Participation and Claiming Credit
This ACC JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions. 

Requesting AMA PRA Category 1 CME Credit™ and/or MOC or ECME credit for this Activity

To request credit, you must:
  1. Read the article for which you wish to receive credit.
  2. Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
  3. After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
  4. For CME or COP credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim.
  5. For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
  6. For ECME credit, click the Claim button in the row for ECME. Please note that you may only claim once for this activity. Enter your date of birth and click Submit.
  7. The page will be updated with the date and time that you claimed your credit.
  8. To view your credit, or to print a certificate, please go to and navigate to the My Transcript section of My ACC.
This CME/MOC/ECME-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC/ECME-certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC/ECME-certified activity.
Availability: On-Demand
Available Nov 18, 2019 to Nov 17, 2020
Cost: FREE
Credit Offered: 1 CME Credit
1 ECME Credit
1 MOC Credit
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