title: A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet.
abstract: BACKGROUND
  Pacing in the Bachmann's bundle (BB) area (upper atrial septum) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation in patients with atrial conduction delay. However, insertion of active fixation lead in the upper atrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this pacing method in routine practice.
  
  
  METHODS
  The technique of positioning the atrial lead in BB with hand-made stylet is presented with emphasis on electrocardiographic P-wave pattern and fluoroscopic landmarks.
  
  
  RESULTS
  The results demonstrate an acute implantation and short-term success of BB pacing of 14 patients out of 15 patients without major complications. Pacing parameters at implantation and 3 months postprocedure were noted which were within normal limits.
  
  
  CONCLUSIONS
  These favorable initial results indicate that the positioning of active fixation atrial lead in BB with fluoroscopic landmarks is feasible and reproducible with a simple technique.
authors: RMO-cum-Clinical Tutor, Department of Cardiology, IPGME&R and SSKM Hospital, Kolkata, India. Electronic address: dradascard@rediffmail.com.
authors: Asit
authors: A
authors: Das
authors: Senior Interventional Cardiologist, Apollo Gleneagles Hospitals, Kolkata, India.
authors: Suvro
authors: S
authors: Banerjee
authors: Professor, Department of Cardiology, IPGME&R and SSKM Hospital, Kolkata, India.
authors: S C
authors: SC
authors: Mandal
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Bachmann's bundle; Hand-made stylet; Pacing