Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 5, September-October, p. 845–850

doi: 10.17219/acem/63351

Publication type: original article

Language: English

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Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Agnieszka Sławuta1,A,B,C,D,E,F, Magdalena Kliś2,B,C,D,E, Przemysław Skoczyński3,B,C,E, Tomasz Bańkowski4,B,C, Joanna Moszczyńska-Stulin4,A,B,C, Jacek Gajek5,A,B,C,D,E,F

1 Department of Cardiology, Klodzko County Hospital, Kłodzko, Poland

2 Department of Cardiology, Wroclaw Provincial Specialist Hospital, Poland

3 Department of Emergency Medicine, Wroclaw Medical University Hospital, Poland

4 Department of Cardiology, Wroclaw Medical University Hospital, Poland

5 Department and Clinic of Cardiology, Wroclaw Medical University, Poland

Abstract

Background. Patients treated for sick sinus syndrome may have interatrial conduction disorder leading to atrial fibrillation.
Objectives. 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.
Material and 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).
Conclusion. 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.

Key words

atrial pacing, sick sinus syndrome, right atrial appendage, Bachmann’s bundle, atrioventricular conduction

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