AI-Enabled ECG Mapping to Guide Leadless Atrial Pacemaker Implantation in the Bachmann's Bundle Region

Q: What does this research mean for the field?

AI-enabled ECG mapping can successfully guide leadless pacemaker implantation in the Bachmann's bundle region to facilitate physiologic atrial pacing. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Dingxin Qin; David E. Krummen; Ayesha Shaik; Shaan Khurshid; William J. Hucker; Moussa Mansour; Jagmeet P. Singh

doi:10.1016/j.jaccas.2026.109578

July 1, 2026JACC Case ReportsOpen Access

AI-Enabled ECG Mapping to Guide Leadless Atrial Pacemaker Implantation in the Bachmann's Bundle Region

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Why the study?

Physiologic atrial pacing at the Bachmann's bundle region may improve biatrial synchrony, but accurate implantation of atrial leadless pacemakers remains challenging.

Does AI-enabled ECG mapping facilitate successful implantation of an atrial leadless pacemaker in the Bachmann's bundle region in a patient with tachy-brady syndrome?

Key Points

To evaluate the feasibility of utilizing artificial intelligence-enabled electrocardiogram mapping to guide atrial leadless pacemaker implantation in the Bachmann's bundle region.
Treated an 86-year-old woman presenting with symptomatic tachy-brady syndrome and bilateral subclavian venous occlusion.
Performed leadless atrial pacemaker implantation guided simultaneously by intracardiac echocardiography and artificial intelligence-enabled electrocardiogram mapping.
Electrocardiogram mapping confirmed earliest activation in the anterior-superior left atrium, verifying targeted pacing at the Bachmann's bundle region.
The leadless device was deployed successfully without procedural complications.

Structured PICO

Does AI-enabled ECG mapping facilitate successful implantation of an atrial leadless pacemaker in the Bachmann's bundle region in a patient with tachy-brady syndrome?

P

Population

An 86-year-old woman with symptomatic tachy-brady syndrome and bilateral subclavian venous occlusion (n=1)

I

Intervention

Implantation of an atrial leadless pacemaker in the Bachmann's bundle region guided by intracardiac echocardiography and AI-enabled ECG mapping

O

Outcome

Successful implantation without procedural complicationssafety

This first-in-human report demonstrates the feasibility of using AI-enabled ECG mapping to guide precise implantation of an atrial leadless pacemaker in the Bachmann's bundle region.

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Implication

Hypothesis-generating for AI-guided Bachmann's bundle leadless pacing; prospective trials needed before clinical adoption.

Abstract

BACKGROUND: Physiologic atrial pacing at the Bachmann's bundle region may improve biatrial synchrony, but accurate implantation of atrial leadless pacemakers remains challenging. FIH/EARLY REPORT SUMMARY: We report the first case of artificial intelligence (AI)-enabled electrocardiogram (ECG) mapping-guided implantation of an atrial leadless pacemaker in the Bachmann's bundle region. An 86-year-old woman with symptomatic tachy-brady syndrome and bilateral subclavian venous occlusion underwent implantation of an atrial leadless pacemaker guided by intracardiac echocardiography and AI-enabled ECG mapping. Mapping demonstrated earliest activation in the anterior-superior left atrium, consistent with Bachmann's-bundle-region pacing. Implantation was successful without procedural complications. DISCUSSION: This case demonstrates the feasibility of AI-enabled mapping to facilitate physiologic atrial leadless pacing. NOVELTY: First reported use of AI-enabled ECG mapping to guide Bachmann's-bundle-region atrial leadless pacemaker implantation. TAKE-HOME MESSAGE: AI-enabled ECG mapping may enable precise targeting of the Bachmann's bundle region to achieve individualized physiologic atrial pacing.

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Cite This Study

Qin et al. (2026) studied this question.

synapsesocial.com/papers/6a7e2891a9e316b34539905c https://doi.org/10.1016/j.jaccas.2026.109578

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AI-Enabled ECG Mapping to Guide Leadless Atrial Pacemaker Implantation in the Bachmann's Bundle Region

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Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

AI-Enabled ECG Mapping to Guide Leadless Atrial Pacemaker Implantation in the Bachmann's Bundle Region

Figures

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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