Clinical impact of Bachmann’s bundle pacing defined by electrocardiographic criteria on atrial arrhythmia outcomes

Margaret Infeld, Charles D. Nicoli, Sean Meagher, Bradley J. Tompkins, Shawn Wayne, Benjamin Irvine, Omkar Betageri, Nicole Habel, Sean Till, Jennings Lobel, Markus Meyer, Daniel L. Lustgarten

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Aims Evaluate whether Bachmann’s bundle pacing (BBp) defined by electrocardiographic (ECG) criteria is associated with less atrial fibrillation/tachycardia (AF/AT) compared with anatomically defined right atrial septal pacing (RASp) and right atrial appendage pacing (RAAp). Methods This is a retrospective study comparing BBp with non-specific RASp and RAAp on new incidence, burden, and re- and results currence of AF/AT. We included patients who underwent atrial lead placement between 2006 and 2019 and received > 20% atrial pacing. BBp was defined by paced P-wave morphology and fluoroscopic lead position. Compared with RASp (n = 107) and RAAp (n = 108), AF/AT burden was lower in the BBp (n = 134) group by repeated measures ANOVA (P < 0.001). Over 2-year follow-up, AF/AT burden increased in the RASp (P < 0.01) and RAAp (P < 0.01) groups but did not significantly change in the BBp group (P = 0.91). Atrial arrhythmia burden was lower in the BBp group than the RASp and RAAp groups at 12–15, 18–21, and 24–27 months (P < 0.05) after pacemaker placement. Risk of AF/AT recurrence was lower in BBp than RASp (HR 0.43; P < 0.01) and RAAp patients (HR 0.29, P < 0.01). Risk of de novo AF/AT was also lower in BBp than in RASp (OR 0.12; P < 0.01) and RAAp patients (OR 0.20, P < 0.01). Conclusion Bachmann’s bundle pacing defined using P-wave criteria was associated with decreased atrial arrhythmia burden, recurrence, and de novo incidence compared with right atrial septal pacing and right atrial appendage pacing.

Original languageEnglish (US)
Pages (from-to)1460-1468
Number of pages9
JournalEuropace
Volume24
Issue number9
DOIs
StatePublished - Sep 1 2022

Bibliographical note

Publisher Copyright:
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissions@oup.com.

Keywords

  • Atrial fibrillation
  • Atrial resynchronization
  • Atrial septal pacing
  • Bachmann’s bundle pacing
  • Electrocardiograph
  • Interatrial conduction delay
  • P-wave
  • Right atrial appendage pacing
  • Sinus node dysfunction
  • Humans
  • Tachycardia
  • Boronic Acids
  • Heart Septal Defects, Atrial
  • Cardiac Pacing, Artificial/methods
  • Benzophenones
  • Electrocardiography
  • Retrospective Studies
  • Atrial Fibrillation/diagnosis

PubMed: MeSH publication types

  • Journal Article

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