This review evaluates the mechanisms and clinical consequences of interatrial dyssynchrony, and assesses Bachmann bundle pacing (BBP) as a strategy to restore physiological atrial activation and reduce arrhythmia burden.
Conventional atrial pacing may worsen atrial dyssynchrony rather than correct it; BBP targets the dominant interatrial conduction pathway and emerging data suggest it may improve atrial synchrony, optimize AV timing, and reduce arrhythmia burden.
No original data are presented; evidence for BBP is described as 'emerging,' with no defined optimal implantation strategy or established clinical outcomes data yet available.
Clinicians should recognize that standard right atrial pacing can exacerbate interatrial dyssynchrony — Bachmann bundle pacing is a promising alternative but remains investigational pending larger trials to clarify technique and outcomes.
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