KEY TEACHING POINTS

•His bundle pacing allows for physiologic activation of the ventricles and is feasible for cardiac resynchronization in patients with left bundle branch block. •The absence of myocardial scar as seen in this case may predict the best response to His bundle pacing for systolic function recovery. •Pure His capture may not be necessary to achieve cardiac resynchronization as the hyper-response observed in this case resulted from parahisian or nonselective capture of the His bundle.