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June 27, 2026EP EuropaceOpen Access

Bachmann's bundle pacing achieves 95% implantation success with transitions confirming capture.

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Why the study?

Bachmann bundle pacing offers clinical benefits only when the lead effectively captures Bachmann's bundle, but historical implant techniques have relied on fluoroscopy and unipolar mapping.

Does Bachmann bundle pacing lead implantation demonstrate transition patterns to confirm capture in patients requiring an atrial lead?

Population

136 serial patients undergoing device implantation requiring an atrial lead

Design

Non-randomized observational study

Key result

Bachmann's bundle lead implantation was successful in 95% of patients, with transitions observed in 91% of successful implants in sinus rhythm to assist in confirming capture.

Authors

MEM EricksonNTN TomassoniRSR Sun

Discussion

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Overview

Supports procedural feasibility in selected patients; leaves open whether benefits extend to outcomes versus standard approaches.

Key Points

  • This study aims to evaluate the properties of Bachmann bundle pacing and confirm effective lead capture through transition patterns.
  • Non-randomized observational study of 136 patients undergoing device implantation from April 2024 to July 2025.
  • Bipolar mapping of the Bachmann region was performed during lead implantation to assess capture transitions.
  • Data on demographics, medical history, and procedural details were collected alongside follow-up echocardiographic evaluations.
  • 130 leads were successfully implanted, yielding a 95% success rate.
  • In sinus rhythm, 108 of 118 implants (91%) exhibited transition patterns, primarily from non-selective to selective capture at 79%.
  • The mean reduction in p-wave duration was 11ms, and 20ms specifically with selective pacing.

Study Design

Type

Observational (n=136)

Structured PICO

Does Bachmann bundle pacing lead implantation demonstrate transition patterns to confirm capture in patients requiring an atrial lead?

P
Population
136 patients undergoing device implantation requiring an atrial lead, evaluated for Bachmann bundle lead implant success and transition patterns.
E
Exposure
Bachmann bundle pacing (BBP) lead implantation with decremental output testing
O
Outcome
Successful lead implantation rate and presence of transition patterns during decremental outputsurrogate

Bachmann bundle pacing is highly feasible, and observing transition patterns during decremental output can effectively confirm selective capture, which is associated with significant reductions in p-wave duration.

Cite This Study

Erickson et al. (2026) conducted an observational in Device implantation requiring an atrial lead (n=136). Bachmann bundle lead implantation was evaluated on Successful lead implantation. Bachmann's bundle lead implantation was successful in 95% of patients, with transitions observed in 91% of successful implants in sinus rhythm to assist in confirming capture.

synapsesocial.com/papers/6a3f97bb125782b61d8658dahttps://doi.org/10.1093/europace/euag105.733
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Bachmann's bundle pacing implantation using a P-wave amplitude-guided approach: a single-center experience2026
  2. 2Electrophysiological characterization of the Bachmann bundle region using 3D electroanatomical mapping and peak frequency analysis during pacemaker lead implantation2026
  3. 3Leadless Atrial Pacing at Bachmann's Bundle Guided by Electroanatomic Mapping and Intracardiac Ultrasound2026
  4. 4Acute P wave and procedural characteristics during Bachmann bundle pacing in patients with interatrial conduction delay2026
  5. 5Leadless Atrial Pacing Targeting Bachmann's Bundle for Atrial Resynchronization2025 · 5 citations