Atrial Reverse Remodeling by Bachmann's Bundle Pacing With Improved Interatrial Dyssynchrony: Case Series

BACKGROUND: Bachmann's bundle pacing (BBp) improves interatrial conduction, but its clinical impact on atrial function has not fully established. METHODS AND RESULTS: We report eight cases of attempted BBp. Three cases met BBp electrocardiographic criteria with significant P-wave shortening and P-wave amplitude increase in the inferior leads, resulting in improved left atrial (LA) function (increased a' velocity, decreased E/e', and reduced LA diameter) and heart failure stabilization. Conversely, the remaining five cases failing to achieve significant P-wave changes showed no such improvements. CONCLUSIONS: Restoring interatrial conduction through successful BBp may optimize LA performance, potentially offering heart failure stabilization.