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Published on: December 11, 2017
Leadless Atrial Pacing at Bachmann's Bundle Guided by Electroanatomic Mapping and Intracardiac Ultrasound
Erin S Harris1, John R Power1, Marc A Miller1
1Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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.
