Key result
Conventional right atrial appendage pacing introduces interatrial dyssynchrony and is associated with an increased incidence of new-onset or recurrent atrial fibrillation.
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Conventional right atrial appendage pacing introduces interatrial dyssynchrony and is associated with increased incidence of atrial fibrillation, prompting interest in alternative sites like the Bachmann bundle area.
The right atrial appendage (RAA) has historically been the favored site for atrial lead implantation due to easy accessibility and stable lead pacing and sensing parameters. However, conventional RAA pacing introduces interatrial dyssynchrony due to delayed activation of the left atrium, which can be detrimental to left atrial mechanical function.1 Furthermore, high burden of RAA pacing as well as prolonged p wave duration have both been associated with increased incidence of new onset or recurrent atrial fibrillation (AF) in patients with cardiac implantable electronic devices.
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Andrew Lin (2026) conducted an editorial in Cardiac implantable electronic devices / Atrial fibrillation. Bachmann Bundle Area Pacing vs. Right atrial appendage (RAA) pacing was evaluated. Conventional right atrial appendage pacing introduces interatrial dyssynchrony and is associated with an increased incidence of new-onset or recurrent atrial fibrillation.
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