Key result
Leadless pacemaker implantation into Bachmann's bundle demonstrates ~80% success with low thresholds and no complications.
Why the study?
Atrial leadless pacemakers currently target the right atrial appendage, risking atrial dyssynchrony.
Is leadless pacemaker implantation into Bachmann's bundle guided by electroanatomic mapping and intracardiac ultrasound feasible and safe?
Case Report (n=5)
Is leadless pacemaker implantation into Bachmann's bundle guided by electroanatomic mapping and intracardiac ultrasound feasible and safe?
Leadless pacemaker implantation into Bachmann's bundle guided by electroanatomic mapping and intracardiac ultrasound is feasible and may offer favorable pacing parameters without intraprocedural complications.
Answers are grounded in this paper and cite their sources.
Supports Bachmann's bundle leadless pacing feasibility in select cases; hypothesis-generating and requires prospective trials before clinical adoption.
Introduction Leadless pacemakers (LPs) offer advantages over transvenous systems, but atrial LPs currently target the right atrial appendage (RAA), risking atrial dyssynchrony. Methods and Results We report five patients in whom electroanatomic mapping and intracardiac ultrasound guided LP implantation into Bachmann's bundle (BB), a site shown to improve interatrial conduction and reduce atrial fibrillation risk. In four of five patients, BB fixation was successful with low pacing thresholds and short P‐wave duration. One patient required conversion to RAA pacing due to high BB pacing thresholds. No intraprocedural complications occurred. Conclusions This series demonstrates the feasibility of leadless BB pacing, though technical challenges warrant further study.
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Harris et al. (2026) conducted a case report in Indication for atrial pacing (n=5). Leadless pacemaker implantation into Bachmann's bundle was evaluated on Successful fixation with low pacing thresholds and short P-wave duration. Leadless pacemaker implantation into Bachmann's bundle was successfully achieved in 4 of 5 patients with low pacing thresholds and no intraprocedural complications.
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