Arrhythmias & electrophysiology
Mapping-guided atrial lead placement determines optimal conduction across Bachmann’s bundle: a rationale for patient-tailored pacing therapy
Authors' conclusion
Pacing from the LRA results in a remarkable decrease of TAT compared with pacing from the LAA or RAA.
Study context
- Population
- Patients undergoing cardiac surgery; high-resolution epicardial mapping of Bachmann's bundle
- Participants
- 34 patients
- Comparison
- Programmed electrical stimulation (PES) from right atrial appendage (RAA) vs LRA vs left atrial appendage (LAA) vs sinus rhythm (SR)
- Outcome
- Total activation time (TAT) of Bachmann's bundle
Main finding
As reported in the abstract
TAT of BB
RAA vs SR: P = 0.464 · LRA vs SR: P = 0.003 · LAA vs SR: P = 0.009
Further findings
| Outcome | P value |
|---|---|
| Reduction of both conduction disorders and TATPatients with reduction during LRA pacing vs Others · 9.8 (7.3-12.3) vs. 4.5 (3.5-6.6)% | P < 0.001 |
- Reduction of both conduction disorders and total activation time (TAT) — Most often achieved during LRA pacing
- N = 13
Activation pattern across Bachmann's bundle (BB)
- LRA pacing: activation started in centre of BB
- n = 15
- RAA or LAA pacing: right- and left-sided conduction across BB, respectively
Original publication
Mapping-guided atrial lead placement determines optimal conduction across Bachmann’s bundle: a rationale for patient-tailored pacing therapy. Europace. Published 16 February 2023. doi:10.
Summarised from the published abstract; every number is checked against it