Arrhythmias & electrophysiologyResearch article
P-wave morphology of Bachmann bundle pacing based on electroanatomic mapping and intracardiac echocardiography
- This study included 20 patients who underwent a catheter ablation for atrial fibrillation
Authors' conclusion
Using a combined definition of the BB using EAM and intracardiac echocardiography, paced P-wave parameters were identified that can be used to confirm BB capture with high sensitivity and specificity, which could be useful when targeting the BB for permanent atrial pacing.
Study context
- Population
- Patients who underwent a catheter ablation for atrial fibrillation
- Participants
- 20 patients
- Comparison
- Paced P-wave criteria against the Bachmann bundle (BB) defined anatomically by electroanatomic mapping (EAM) and intracardiac echocardiography
Main finding
As reported in the abstract
Agreement of echocardiographically identified BB with BB determined by EAM
- In all cases, the echocardiographically identified BB was consistent with the BB determined by EAM
Further findings
Local electrogram (EGMs) at the BBRA
- Local EGMs at the BBRA vary morphologically
P-wave morphology of BBRA pacing
- P-wave duration shorter than that of the sinus rhythm (SR)
- >10 ms
- 12-lead P-wave axes recapitulated normal sinus rhythm (SR) P waves
- Inferior P-wave amplitude increased with BB capture relative to the native SR P wave
- No isoelectric interval pacing centrally at the right atrial BB breakout area
Prediction of the BB when all 4 criteria are met
- sensitivity
- 95%
- specificity
- 86%
Original publication
P-wave morphology of Bachmann bundle pacing based on electroanatomic mapping and intracardiac echocardiography. Heart Rhythm. Published 14 May 2026. doi:10.1016/j.hrthm.2026.05.012
Summarised from the published abstract; every number is checked against it