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Is Bachmann's Bundle the Only Right Site for Single-Site Pacing to Prevent Atrial Fibrillation? Results of a Multicenter Randomized Trial

  • Published:
Cardiac Electrophysiology Review

Abstract

The site of atrial pacing influences atrial activation patterns. It is believed that disparities in atrial activation and repolarization are contributors to the development and recurrence of atrial arrhythmias. We hypothesized that pacing from Bachmann's Bundle would improve clinical outcomes in patients with paroxysmal atrial fibrillation compared to right atrial appendage pacing. Pacing from Bachmann's Bundle results in a significant reduction in P wave duration and improvement in biatrial activation symmetry compared to right atrial appendage pacing. Compared to right atrial appendage pacing, Bachmann's bundle pacing improves sinus rhythm (75% vs. 47% at two years, p < 0.01) in patients with a history of paroxysmal atrial fibrillation. Recent studies have confirmed the benefits of Bachmann's Bundle pacing on atrial activation and rhythm regulation. Thus, Bachman's Bundle should be considered the preferred site for atrial pacing in patients with a history of paroxysmal atrial fibrillation.

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References

  1. Han J, Millet D, Chizzonitti B, Moe GK. Temporal dispersion of recovery of excitability in atrium and ventricle as a function of heart rate. Am Heart J 1966;71:481–487.

    Google Scholar 

  2. Papageorgiou P, Monahan K, Boyle NG, Seifert MJ, Beswick P, Zebede J, Epstein LM, Josephson ME. Site dependent intra-atrial conduction delay. Relationship to initiation of atrial fibrillation. Circulation 1996;94:384–389.

    Google Scholar 

  3. Bachmann G. The inter-auricular time interval. Am J Physiol 1916;4:1309–1320.

    Google Scholar 

  4. Bailin SJ, Johnson WB, Hoyt R. Differential atrial pacing: Implications for atrial activation. Circulation 1995;92:I405 (abstract).

    Google Scholar 

  5. Bennett DH. Comparison of the acute effects of pacing the atrial septum, right atrial appendage, coronary sinus os, and the latter two sites simultaneously on the duration of atrial activation. Heart 2000;84(2):193–196.

    Google Scholar 

  6. Roithinger FX, Abou-Harb M, Pachinger O, Hintringer F. The effect of the atrial pacing site on the total atrial activation time. Pacing Clin Electrophysiol 2001;24(3):316–322.

    Google Scholar 

  7. Gozolits S, Fischer G, Berger T, Hanser F, Abou-Harb M, Tilg B, Pachinger O, Hinitringer F, Roithinger FX. Global P wave duration on the 65-lead ECG: Single-site and dual site pacing in the structurally normal human atrium. J Cardiovasc Electrophysiol 2002;13(12):1240–1245.

    Google Scholar 

  8. Roithinger FX, Abou-Harb M, Pachinger O, Hintringer F. The effect of the atrial pacing site on the total atrial activation time. Pacing Clin Electrophysiol 2001;24(3):316–322.

    Google Scholar 

  9. Bailin SJ, Adler S, Giudici M. Prevention of chronic atrial fibrillation by pacing in the region of bachmann's bundle: Results of a multicenter randomized trial. J Cardiovascular Electrophysiology 2001;12(8):912–917.

    Google Scholar 

  10. Ramdat Misier A, Opthof T, Van Hemel N, Defauw JJ, de Bakker JM, Janse MJ, van Capelle FJ. Increased dispersion of refractoriness in patients with idiopathic paroxysmal atrial fibrillation. J Am Coll Cardiol 1992;19:1531–1535.

    Google Scholar 

  11. Yamada T, Fukunami M, Shimonagata T, Kumagai K, Asano Y, Hirata A, Asai M, Makino N, Hoki N. Effect of atrial septal pacing on P-wave duration dispersion and atrial late potentials in patients with paroxysmal atrial fibrillation. Am J Cardiol 2001;88(7):795–798.

    Google Scholar 

  12. Duytscheaver M, Danse P, Eysbouts S, Allessie M, Is there an optimal pacing site to prevent atrial fibrillation? An experimanetal study in the chronically intrumentedngoat. J Cardiovasc Electrophysiol 2002;13(12):1264–1271.

    Google Scholar 

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Authors and Affiliations

  1. Iowa Heart Center, Director of Electrophysiology, Iowa Heart Hospital at Mercy, Des Moines, IA

    Steven J. Bailin

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  1. Steven J. Bailin
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Bailin, S.J. Is Bachmann's Bundle the Only Right Site for Single-Site Pacing to Prevent Atrial Fibrillation? Results of a Multicenter Randomized Trial. Card Electrophysiol Rev 7, 325–328 (2003). https://doi.org/10.1023/B:CEPR.0000023131.13609.ab

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  • DOI: https://doi.org/10.1023/B:CEPR.0000023131.13609.ab

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