title: Bachmann's Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing.
abstract: BACKGROUND
  Patients treated for sick sinus syndrome may have interatrial conduction disorder leading to atrial fibrillation.
  
  
  OBJECTIVE
  This study was aimed to assess the influence of the atrial pacing site on interatrial and atrioventricular conduction as well as the percentage of ventricular pacing in patients with sick sinus syndrome implanted with atrioventricular pacemaker.
  
  
  METHODS
  The study population: 96 patients (58 females, 38 males) aged 74.1 ± 11.8 years were divided in two groups: Group 1 (n = 44) with right atrial appendage pacing and group 2 (n = 52) with Bachmann's area pacing. We assessed the differences in atrioventricular conduction in sinus rhythm and atrial 60 and 90 bpm pacing, P-wave duration and percentage of ventricular pacing.
  
  
  RESULTS
  No differences in baseline P-wave duration in sinus rhythm between the groups (102.4 ± 17 ms vs. 104.1 ± 26 ms, p = ns.) were noted. Atrial pacing 60 bpm resulted in longer P-wave in group 1 vs. group 2 (138.3 ± 21 vs. 106.1 ± 15 ms, p < 0.01). The differences between atrioventricular conduction time during sinus rhythm and atrial pacing at 60 and 90 bpm were significantly longer in patients with right atrial appendage vs. Bachmann's pacing (44.1 ± 17 vs. 9.2 ± 7 ms p < 0.01 and 69.2 ± 31 vs. 21.4 ± 12 ms p < 0.05, respectively). The percentage of ventricular pacing was higher in group 1 (21 vs. 4%, p < 0.01).
  
  
  CONCLUSIONS
  Bachmann's bundle pacing decreases interatrial and atrioventricular conduction delay. Moreover, the frequency-dependent atrioventricular conduction lengthening is much less pronounced during Bachmann's bundle pacing. Right atrial appendage pacing in sick sinus syndrome patients promotes a higher percentage of ventricular pacing.
authors.affiliation: Department of Cardiology, Klodzko County Hospital, Kłodzko, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sławuta
authors.affiliation: Department of Cardiology, Wroclaw Provincial Specialist Hospital, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kliś
authors.affiliation: Department of Emergency Medicine, Wroclaw Medical University Hospital, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Skoczyński
authors.affiliation: Department of Cardiology, Wroclaw Medical University Hospital, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bańkowski
authors.affiliation: Department of Cardiology, Wroclaw Medical University Hospital, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Moszczyńska-Stulin
authors.affiliation: Department and Clinic of Cardiology, Wroclaw Medical University, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Gajek
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D003710:Demography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male
keywords: Bachmann’s bundle; atrial pacing; atrioventricular conduction; right atrial appendage; sick sinus syndrome