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Case Reports
. 2025 Apr 30:S1547-5271(25)02319-7.
doi: 10.1016/j.hrthm.2025.04.012. Online ahead of print.

The Bachmann Bundle Pacing Target: Retrograde Mapping and Microstructural Correlation

Daniel L Lustgarten  1 , Nicole Habel  2 , Margaret Infeld  3 , Daniel Correa de Sa  2 , Robert Lobel  2 , Peter Spector  2 , Nathaniel Thompson  2 , Joseph Winget  2 , Neal Duong  4 , Bo Ye  5 , Paul A Iaizzo  6 , Markus Meyer  5
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Case Reports

The Bachmann Bundle Pacing Target: Retrograde Mapping and Microstructural Correlation

Daniel L Lustgarten et al. Heart Rhythm. .

Abstract

Electroanatomic mapping of the right atrial breakout site during retrograde Bachmann bundle pacing in 15 patients in sinus rhythm undergoing pulmonary vein isolation provided the anatomic localization of the putative lead insertion target for Bachmann bundle pacing. In all patients the target area could be mapped to the inferoseptal superior vena cava, with some variation in the earliest breakout site in the anteroposterior plane. Microstructural correlation reveals that the Bachmann bundle functions as an atrial conduction pathway supported by anatomic features to provide interatrial synchrony.

Keywords: Alternate site pacing; Atrial activation; Atrial resynchronization; Bachmann bundle electrogram; Bachmann bundle pacing; Conduction system pacing.

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Conflict of interest statement

Disclosures Drs Lustgarten, Habel, Iaizzo, and Meyer have received research funding from Medtronic. Dr Meyer has received research funding from the Engdahl Family Foundation. Dr Infeld has received speaker fees from Medtronic.

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