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June 27, 2026EP EuropaceOpen Access

Successful Bachmann's bundle pacing was achieved in 88% (44/50) of patients, with mean capture threshold improving to 0.834±0.315 V at procedure end and no major complications at 6 months.

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Why the study?

Is a P-wave amplitude-guided implantation strategy for Bachmann's bundle pacing feasible and safe in patients requiring pacemaker or ICD implantation?

Population

50 patients undergoing dual-chamber pacemaker or implantable cardioverter-defibrillator implantation with…

Design

Cohort

Follow-up

6 months

Authors

DYD YoshimotoYSY SakamotoYUY Uemura

Discussion

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Overview

High success suggests BBp feasibility via atrial septal leads; leaves open need for randomized outcome trials.

Key Points

  • To assess the feasibility, safety, and short-term effects of a P-wave amplitude-guided implantation strategy for Bachmann’s bundle pacing.
  • Retrospective inclusion of 50 patients undergoing dual-chamber pacemaker or ICD with attempted BBp.
  • Identified SVC–RA junction via a 'jump-up' in local atrial electrogram amplitude at pacing lead.
  • Pacing lead was implanted just below the junction based on amplitude findings.
  • Successful atrial septal lead implantation in all 50 patients; 88% achieved successful BBp based on ECG criteria.
  • Mean capture threshold decreased from 1.86±1.00 V to 0.834±0.315 V during the procedure.
  • Stable pacing parameters observed after 6 months, no major complications or deaths reported.

Structured PICO

Is a P-wave amplitude-guided implantation strategy for Bachmann's bundle pacing feasible and safe in patients requiring pacemaker or ICD implantation?

P
Population
50 patients undergoing dual-chamber pacemaker or implantable cardioverter-defibrillator implantation with attempted Bachmann's bundle pacing
I
Intervention
Bachmann's bundle pacing (BBp) using a P-wave amplitude-guided implantation strategy with a lumenless pacing lead and delivery catheter
O
Outcome
Feasibility, safety, and short-term outcomes (successful BBp, mapping time, capture thresholds, complications)safety

A P-wave amplitude-guided approach for Bachmann's bundle pacing is feasible, safe, and reproducible, with stable short-term pacing parameters.

Cite This Study

Yoshimoto et al. (2026) studied this question.

synapsesocial.com/papers/6a3f9785125782b61d8657ddhttps://doi.org/10.1093/europace/euag105.685
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Also Consider

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

  1. 1Acute P wave and procedural characteristics during Bachmann bundle pacing in patients with interatrial conduction delay2026
  2. 2Electrophysiological characterization of the Bachmann bundle region using 3D electroanatomical mapping and peak frequency analysis during pacemaker lead implantation2026
  3. 3Properties during implant and the presence of transitions to confirm capture of Bachmann's Bundle2026
  4. 4Dual-Site Conduction System Pacing: A Case Report of Combined Left Bundle Branch Area Pacing and Bachmann Bundle Pacing2025
  5. 5Feasibility and six-month stability of novel posterosuperior bundle pacing for interatrial synchrony using a stylet-driven fixed-helix pacing lead2026