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Abstract : In patients with total atrioventricular block that is not reversible or not caused by physiological causes, permanent pacing is indicated regardless of symptoms. His bundle pacing can avoid electrical and mechanical dyssynchrony induced by myocardial pacing because it uses the intrinsic pathway of myocardial activation. This case discusses the approach of implanting permanent non-selective His bundle pacing with stylet-driven lead technique in a 62-year-old female patient with total atrioventricular block and vascular anomaly in the left brachiocephalic vein. We modified the implant technique to place the lead in the His bundle area and successfully confirmed non-selective His bundle pacing from intracardiac electrogram and surface ECG.