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April 13, 2026Pacing and Clinical Electrophysiology

Overall, acute LAP was not significantly different between BBP and RAAP (p > 0.05), though BBP was associated with lower acute LAP compared to RAAP in the subgroup with interatrial conduction delay (16.7 ± 5.5 mmHg vs. 17.0 ± 6.0 mmHg, p = 0.010).

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Why the study?

Does Bachmann's bundle pacing reduce acute left atrial pressure compared to right atrial appendage pacing in patients undergoing left atrial catheter ablation?

Population

26 subjects undergoing left atrial catheter ablation in sinus rhythm.

Comparison

Bachmann's bundle pacing performed at the end of… vs Right atrial appendage pacing and sinus rhythm.

Design

Cross-sectional

Authors

ETE W X TanWLWei Yao LimAKAnand Kailasam

Discussion

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Overview

Bachmann's bundle pacing reduces p-wave duration but does not uniformly reduce acute left atrial pressure compared to right atrial appendage pacing, except in patients with baseline interatrial conduction delay.

Key Points

  • To compare acute left atrial pressure and p-wave duration during Bachmann's bundle pacing and right atrial appendage pacing.
  • Measured acute left atrial pressure and p-wave duration in subjects during sinus rhythm, BBP, and RAAP.
  • Used paired t-tests to analyze differences in p-wave duration and left atrial pressure.
  • Included 26 subjects undergoing left atrial catheter ablation.
  • Bachmann's bundle pacing resulted in significantly shorter p-wave duration compared to sinus rhythm and RAAP (p < 0.05).
  • Left atrial pressure was similar among BBP, sinus rhythm, and RAAP in most groups, but lower in BBP compared to RAAP among subjects with interatrial conduction delay (p = 0.010).
  • Adjusting for age, p-wave duration showed a significant association with left atrial pressure in sinus rhythm (ß 0.12, p = 0.039).

Structured PICO

Does Bachmann's bundle pacing reduce acute left atrial pressure compared to right atrial appendage pacing in patients undergoing left atrial catheter ablation?

P
Population
26 subjects undergoing left atrial catheter ablation in sinus rhythm (age 56.6 ± 14.2 years, 27% female, 11% left-sided accessory pathway ablation, 54% pulmonary vein isolation [PVI], 35% PVI+additional LA ablation).
I
Intervention
Bachmann's bundle pacing (BBP) performed at the end of ablation.
C
Comparator
Right atrial appendage pacing (RAAP) and sinus rhythm.
O
Outcome
Acute left atrial pressure (LAP) measured invasively.surrogate

Bachmann's bundle pacing reduces p-wave duration but does not uniformly reduce acute left atrial pressure compared to right atrial appendage pacing, except in patients with baseline interatrial conduction delay.

Cite This Study

Tan et al. (2026) studied this question.

synapsesocial.com/papers/69dc89183afacbeac03ead82https://doi.org/10.1111/pace.70255
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparable acute hemodynamic effects of left bundle branch pacing delivered from the right and left ventricular septum2026
  2. 2Biatrial activation patterns and hemodynamics during Bachmann bundle pacing: learnings from a porcine model2026
  3. 3Left Bundle Branch Area Pacing Improves Left Atrial Outcomes in Pacemaker-Dependent Patients: A Prospective Cohort Study Using Speckle Tracking and Three-Dimensional Echocardiography.2025 · 1 citations
  4. 4Acute P wave and procedural characteristics during Bachmann bundle pacing in patients with interatrial conduction delay2026
  5. 5Bachmann's bundle pacing implantation using a P-wave amplitude-guided approach: a single-center experience2026