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July 12, 2026Journal of Interventional Cardiac Electrophysiology

Electrophysiological characterization of the Bachmann bundle region using 3D electroanatomical mapping and peak frequency analysis during pacemaker lead implantation

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Key result

3D EAM identifies 400-500 Hz as the optimal Bachmann bundle frequency, correlating with P-wave shortening.

  • AUC 0.83; r = -0.66
  • P=0.02
  • n=12

Why the study?

Does 3D electroanatomical mapping with peak-frequency analysis accurately characterize the Bachmann bundle area during pacemaker lead implantation?

Population

12 consecutive patients undergoing dual-chamber pacemaker implantation with the atrial lead positioned in…

Design

Cohort

Follow-up

3 months

Authors

IOIngrid OvereinderHeart Rhythm SocietyLPLuigi PannoneHeart Rhythm SocietyIEIvan EltsovHeart Rhythm Society

Discussion

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Implication

BBA electrogram mapping may refine atrial pacing targets; leaves open prospective outcome trials.

Key Points

  • This study aims to characterize the Bachmann bundle's electrogram features using advanced mapping techniques during pacemaker lead implantation.
  • Twelve patients underwent dual-chamber pacemaker implantation targeting the Bachmann bundle area.
  • 3D electroanatomical mapping and peak frequency analysis were employed to evaluate electrograms before and after lead positioning.
  • P-wave duration and pacing thresholds were assessed to analyze procedural outcomes.
  • The optimal peak frequency band for localizing the Bachmann bundle was identified as 400-500 Hz (AUC = 0.83, sensitivity 87%, specificity 80%).
  • Lead fixation correlated with a significant peak frequency decrease and P-wave shortening (r = -0.66, p = 0.02).
  • All leads remained stable at three-month follow-up with normal pacing parameters.

Study Design

Type

Observational (n=12)

Structured PICO

Does 3D electroanatomical mapping with peak-frequency analysis accurately characterize the Bachmann bundle area during pacemaker lead implantation?

P
Population
12 consecutive patients undergoing dual-chamber pacemaker implantation with the atrial lead positioned in the Bachmann bundle area, followed for 3 months.
E
Exposure
3D electroanatomical mapping (EAM) with peak-frequency (PF) analysis during atrial lead implantation in the Bachmann bundle area
O
Outcome
Optimal peak-frequency (PF) band for Bachmann bundle area localization and correlation of PF changes with P-wave durationsurrogate

Main Result

Effect estimate: AUC 0.83; r = -0.66

p-value: p=0.02

3D electroanatomical mapping with peak-frequency analysis can identify the Bachmann bundle area (optimal band 400-500 Hz) and correlates lead fixation with P-wave shortening, potentially guiding physiological atrial pacing.

Cite This Study

Overeinder et al. (2026) conducted an observational in Dual-chamber pacemaker implantation (n=12). 3D electroanatomical mapping and peak frequency analysis was evaluated on Optimal peak frequency band for Bachmann bundle area localization and correlation with P-wave shortening (AUC 0.83; r = -0.66, p=0.02). 3D electroanatomical mapping identified the optimal peak frequency band for Bachmann bundle area localization as 400–500 Hz (AUC=0.83), and PF reductions correlated with P-wave shortening (r=-0.66, P=0.02).

synapsesocial.com/papers/6a5335384f7abc118adee353https://doi.org/10.1007/s10840-026-02394-8
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