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Updated: Aug 13, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Bachmann Bundle Pacing Combined with ICD in Hypertrophic Cardiomyopathy with Interatrial Conduction Block

Shengjie Wu1, Kelly Q Jia2, Xiangxiang Shi1

  • 1Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, 325000, People's Republic of China.

Cardiac Electrophysiology Clinics
|August 11, 2026
PubMed

Insights

This study shows Bachmann bundle pacing (BBP) with an implantable cardioverter-defibrillator (ICD) effectively treats hypertrophic cardiomyopathy (HCM) patients with interatrial conduction delay. BBP improved heart function and reduced heart failure symptoms.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Familial hypertrophic cardiomyopathy (HCM) can cause severe heart failure and interatrial conduction delay (IACD).
  • Standard cardiac resynchronization therapy may be unsuitable for some HCM patients due to specific ventricular activation patterns.
  • Optimizing atrial synchrony is crucial for improving cardiac function in these patients.

Purpose of the Study:

  • To evaluate the efficacy of Bachmann bundle pacing (BBP) combined with a dual-chamber implantable cardioverter-defibrillator (ICD) in a patient with HCM, severe heart failure, and IACD.
  • To assess the impact of BBP on interatrial synchrony, left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) functional class.
  • To explore BBP as a novel therapeutic strategy for managing complex cardiac conditions in HCM.

Main Methods:

  • A 67-year-old male patient with HCM, LVEF 31%, NYHA III, and IACD underwent implantation of a dual-chamber ICD.
  • The atrial lead was positioned using Bachmann bundle pacing (BBP) to enhance interatrial synchrony.
  • Clinical status, echocardiographic parameters, and P-wave characteristics were monitored post-implantation.

Main Results:

  • Bachmann bundle pacing successfully corrected the interatrial conduction delay, evidenced by P-wave shortening and normalization.
  • Within one month, the patient showed significant clinical improvement: LVEF increased from 31% to 49%, and NYHA class improved from III to II.
  • Echocardiography demonstrated improved left atrial-left ventricular coupling, indicating enhanced cardiac efficiency.

Conclusions:

  • The combination of BBP and ICD provides a novel and effective treatment for HCM patients suffering from IACD.
  • This strategy offers dual benefits: protection against sudden cardiac death and substantial hemodynamic and functional improvements.
  • Optimizing atrial activation and atrioventricular synchrony through BBP is key to achieving these positive outcomes in challenging cardiac cases.

Keywords:
Bachmann bundleHypertrophic cardiomyopathyImplantable cardioverter-defibrillatorInteratrial conduction delay

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