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March 31, 2026HeartRhythm Case Reports1 citationsOpen Access

Septal Implantation of a Leadless Atrial Pacemaker: Relevant Anatomy for Alternate Sites into Bachmann’s Area

ABAlexandra BrigidoJMJake MartinezRTRoderick Tung

Structured PICO

P
Population
1 78-year-old woman with sick sinus syndrome, symptomatic bradycardia (heart rates in the 30s), non-perfusing ventricular escape beats, chronotropic incompetence, and preserved atrioventricular (AV) conduction.
I
Intervention
Leadless atrial pacemaker (Aveir AR) implanted in the interatrial septum (anterior to the fossa ovalis) guided by intracardiac echocardiography (ICE).
O
Outcome
Device electrical parameters (capture threshold, sensing amplitude, impedance) and P-wave duration.

Septal implantation of a leadless atrial pacemaker guided by intracardiac echocardiography is a feasible alternative when standard right atrial appendage positioning fails, potentially improving interatrial synchrony.

Limitations

  • Long-term follow-up is necessary to rule out aortic injury from potential erosion into the noncoronary sinus of Valsalva.
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Cite This Study

Brigido et al. (2026) studied this question.

synapsesocial.com/papers/6a025ca7edf6f48138594847https://doi.org/10.1016/j.hrcr.2026.03.006
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