open access

Vol 13, No 5 (2018)
Electrotherapy
Published online: 2018-09-07
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Why is it reasonable to pace the Bachmann's bundle? Electrocardiographic and clinical considerations

Magdalena Sokołowska, Jacek Marcin Zawadzki, Aleksandra Gajek, Jakub Adamowicz, Jacek Gajek, Magdalena Kliś, Agnieszka Sławuta
DOI: 10.5603/FC.a2018.0064
·
Folia Cardiologica 2018;13(5):485-488.

open access

Vol 13, No 5 (2018)
Electrotherapy
Published online: 2018-09-07

Abstract

Despite its widely-understood physiological mode, artificial atrial pacing can negatively influence heart performance in
many respects. We present the case of an 80-year-old woman with the signs and symptoms of diastolic heart failure which
had originated, according to the patient herself, due to the implantation of a dual chamber pacemaker inserted for the
treatment of sinus node disease. The atrial electrode was located in the right atrial appendage. Electrocardiographic and
echocardiographic assessment indicated the possibility of a deleterious relationship between the atrial and ventricular
contraction, which could be responsible for patient’s symptoms. Some changes in device programming could contribute to
a clinical improvement. Yet the question remains: should pacing of the Bachmann’s bundle be implemented in our patient?

Abstract

Despite its widely-understood physiological mode, artificial atrial pacing can negatively influence heart performance in
many respects. We present the case of an 80-year-old woman with the signs and symptoms of diastolic heart failure which
had originated, according to the patient herself, due to the implantation of a dual chamber pacemaker inserted for the
treatment of sinus node disease. The atrial electrode was located in the right atrial appendage. Electrocardiographic and
echocardiographic assessment indicated the possibility of a deleterious relationship between the atrial and ventricular
contraction, which could be responsible for patient’s symptoms. Some changes in device programming could contribute to
a clinical improvement. Yet the question remains: should pacing of the Bachmann’s bundle be implemented in our patient?

Get Citation

Keywords

atrial pacing, Bachmann’s bundle pacing, diastolic heart failure

About this article
Title

Why is it reasonable to pace the Bachmann's bundle? Electrocardiographic and clinical considerations

Journal

Folia Cardiologica

Issue

Vol 13, No 5 (2018)

Pages

485-488

Published online

2018-09-07

DOI

10.5603/FC.a2018.0064

Bibliographic record

Folia Cardiologica 2018;13(5):485-488.

Keywords

atrial pacing
Bachmann’s bundle pacing
diastolic heart failure

Authors

Magdalena Sokołowska
Jacek Marcin Zawadzki
Aleksandra Gajek
Jakub Adamowicz
Jacek Gajek
Magdalena Kliś
Agnieszka Sławuta

References (10)
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  2. Rein AJ, O'Donnell CP, Colan SD, et al. Tissue velocity Doppler assessment of atrial and ventricular electromechanical coupling and atrioventricular time intervals in normal subjects. Am J Cardiol. 2003; 92(11): 1347–1350.
  3. Wang K, Xiao HB, Fujimoto S, et al. Atrial electromechanical sequence in normal subjects and patients with DDD pacemakers. Br Heart J. 1995; 74(4): 403–407.
  4. Bąkowski D, Wożakowska-Kapłon B. Blok przedsionkowo-komorowy I stopnia u chorego z dwujamowym kardiowerterem-defibrylatorem — pozornie błahy problem. Folia Cardiol. 2016; 11(1): 75–79.
  5. Eicher JC, Laurent G, Mathé A, et al. Atrial dyssynchrony syndrome: an overlooked phenomenon and a potential cause of 'diastolic' heart failure. Eur J Heart Fail. 2012; 14(3): 248–258.
  6. Kliś M, Sławuta A, Gajek J. Antiarrhythmic properties of atrial pacing. Adv Clin Exp Med. 2017; 26(2): 351–357.
  7. Miyazaki H, Noma K, Date T, et al. Atrial septal pacing to resynchronize atrial contraction and improve atrial transport function. J Cardiol. 2005; 45(6): 239–246.
  8. Bailin SJ, Adler S, Giudici M. Prevention of chronic atrial fibrillation by pacing in the region of Bachmann's bundle: results of a multicenter randomized trial. J Cardiovasc Electrophysiol. 2001; 12(8): 912–917.
  9. Kristensen L, Nielsen JC, Mortensen PT, et al. Sinus and paced P wave duration and dispersion as predictors of atrial fibrillation after pacemaker implantation in patients with isolated sick sinus syndrome. Pacing Clin Electrophysiol. 2004; 27(5): 606–614.
  10. Sławuta A, Kliś M, Skoczyński P, et al. Bachmann's bundle pacing not only improves interatrial conduction but also reduces the need for ventricular pacing. Adv Clin Exp Med. 2016; 25(5): 845–850.

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