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June 27, 2026EP EuropaceOpen Access

BB pacing significantly increased left ventricular mean pressure (56.23 vs 49.06 mmHg, p=0.003) and femoral pressure (77.20 vs 66.29 mmHg, p<0.001) compared to RAA pacing.

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Why the study?

Does Bachmann bundle pacing improve hemodynamics and atrial activation compared to right atrial appendage pacing in a porcine model?

Population

3 Landrace pigs (~50kg) under general anesthesia

Comparison

Bachmann bundle pacing at decremental cycle… vs Right atrial appendage pacing at decremental…

Design

Preclinical

Authors

ARA Gil RamirezJHJ Norup HertelTMT Mohaissen

Discussion

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Overview

No immediate clinical implications from this animal model; leaves open hemodynamic effects in translational research.

Key Points

  • To compare the effects of Bachmann bundle pacing versus right atrial appendage pacing on atrial activation patterns and intracardiac pressure in a porcine model.
  • Three Landrace pigs (~50kg) underwent biatrial electroanatomical mapping and hemodynamic assessment.
  • Atrial pacing was performed from the right atrial appendage and Bachmann bundle at decremental cycle lengths.
  • Blood pressures were recorded from various cardiac chambers and arteries during pacing.
  • BB pacing resulted in a 14.61% increase in left ventricular mean pressure compared to RAA pacing (p=0.003).
  • BB pacing produced higher mean pressures in the left atrium (+7.55%, p=0.01) and femoral artery (+16.45%, p<0.001).
  • Total atrial activation time was shorter with BB pacing (80ms vs 125ms, p=0.25), but not statistically significant.

Structured PICO

Does Bachmann bundle pacing improve hemodynamics and atrial activation compared to right atrial appendage pacing in a porcine model?

P
Population
3 Landrace pigs (~50kg) under general anesthesia
I
Intervention
Bachmann bundle (BB) pacing at decremental cycle lengths
C
Comparator
Right atrial appendage (RAA) pacing at decremental cycle lengths
O
Outcome
Intracardiac pressure responses and atrial activation patternssurrogate

Bachmann bundle pacing acutely improves left-sided hemodynamics compared to traditional right atrial appendage pacing in a porcine model.

Cite This Study

Ramirez et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97a5125782b61d86586chttps://doi.org/10.1093/europace/euag105.734
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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. 2Comparison of Invasive Left Atrial Pressure Between Bachmann's Bundle and Right Atrial Appendage Pacing2026
  3. 3Bachmann's bundle pacing implantation using a P-wave amplitude-guided approach: a single-center experience2026
  4. 4Atrial Dyssynchrony and Bachmann Bundle Pacing2026
  5. 5Electrophysiological characterization of the Bachmann bundle region using 3D electroanatomical mapping and peak frequency analysis during pacemaker lead implantation2026