Atrial Synchrony Restored With Bachmann Bundle Pacing.

CASE SUMMARY: Capturing intrinsic interatrial conduction with Bachmann bundle (BB) pacing is known as a more physiological atrial pacing strategy than conventional right atrial appendage pacing. We present a 74-year-old man with sinus node dysfunction and paroxysmal atrial fibrillation who underwent dual-chamber pacemaker implantation, incorporating BB and left bundle branch ventricular pacing. Interatrial and atrioventricular synchrony was achieved with a shorter P-wave duration and normalization of the PR interval.

TAKE-HOME MESSAGE: BB pacing may restore physiologic atrial activation by engaging the preferential interatrial conduction pathway and may be beneficial in patients with sinus node dysfunction and atrial arrhythmias.