A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet.

Area of Science:

• Electrophysiology
• Cardiac Pacing

Background:

• Bachmann's bundle (BB) pacing shows promise for preventing paroxysmal atrial fibrillation in patients with atrial conduction delay.
• However, conventional methods for active fixation lead insertion in the BB area are challenging, limiting clinical adoption.

Purpose of the Study:

• To present a simplified technique for positioning an active fixation atrial lead in the Bachmann's bundle area.
• To evaluate the feasibility and reproducibility of this new method.

Main Methods:

• A novel technique utilizing a hand-made stylet for atrial lead placement in the BB area is described.
• Emphasis is placed on electrocardiographic P-wave patterns and fluoroscopic landmarks for accurate positioning.

Main Results:

• Successful acute implantation was achieved in 14 out of 15 patients.
• Short-term follow-up demonstrated no major complications, with pacing parameters within normal limits at implantation and 3 months post-procedure.

Conclusions:

• The described technique for active fixation atrial lead positioning in the BB area is feasible and reproducible.
• This simplified approach may facilitate the routine application of BB pacing for atrial fibrillation prevention.