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Men and women's hearts don't beat the same: Epicardial mapping of Bachmann's bundle

Anouk I Freriks1, Nicole L M de Kruijf1,2, Mathijs S van Schie1

  • 1Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|November 11, 2025
PubMed

Insights

Sex differences in Bachmann's bundle (BB) electrical properties were found in atrial fibrillation (AF) patients. Women exhibit more low-voltage areas and abnormal potentials, suggesting a distinct AF substrate in BB.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Sex Differences in Medicine

Background:

  • Atrial fibrillation (AF) presentation and progression vary between sexes.
  • Bachmann's bundle (BB) is crucial for interatrial conduction.
  • Sex-related differences in BB remodeling may influence AF development.

Purpose of the Study:

  • To investigate sex differences in Bachmann's bundle (BB) electrophysiological properties in AF patients.
  • To assess electrical remodeling using high-resolution and density mapping.

Main Methods:

  • Recorded sinus rhythm in BB from 108 AF patients (35 women, 73 men) during surgery.
  • Assessed potential voltage, low-voltage area (LVA), conduction heterogeneity, and potential morphology.
  • Analyzed unipolar potential morphology and conduction velocity.

Main Results:

  • Women showed significantly lower potential voltages (0.7 mV vs 1.1 mV) compared to men.
  • Women had a higher proportion of low-voltage areas (10.8% vs 4.3%) and double potentials (11.1% vs 5.0%).
  • These findings indicate greater electrical abnormalities in women's BB.

Conclusions:

  • Observed significant sex-related differences in the electrical remodeling of BB in AF patients.
  • Women exhibit a higher prevalence of low-voltage potentials and abnormal morphologies in BB.
  • These differences may underlie sex-specific substrates contributing to AF in women.
Abstract

Keywords:
Atrial fibrillationBachmann’s bundleElectrophysiological propertiesSex difference

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