Work

Bachmann’s bundle and upper septal inter-atrial connections as key paths for a biatrial macro re-entrant circle: a case report

Year: 2025

Type: article

Abstract: Background: The Bachmann's bundle has been described as a key route for re-entrant circuits in biatrial tachycardias. Septal inter-atrial muscular connections were discovered a while ago, but evidence on their potential role in re-entrant tachycardias is lacking. Case summary: We describe an atrial macro re-entrant circuit presented as a wide complex tachycardia that utilized the Bachmann's bundle, septal inter-atrial connections, and a limited area of the anterior left atrial myocardium in a patient with previous multiple atrial fibrillation ablation procedures. This tachycardia was diagnosed by using a combination of electrophysiological visualization modalities and was terminated by a single radiofrequency application. Discussion: The inter-atrial muscular connections can pose a major contribution to the mechanism of biatrial tachycardias, especially in patients after extensive left atrial ablation. Thorough mapping modalities, including entrainment stimulation, facilitate a correct diagnosis. Understanding inter-atrial connection anatomy is crucial for the detection and successful ablation of such tachycardia.

Source: European Heart Journal - Case Reports

DOI: 10.1093/ehjcr/ytaf119

Authors: Heber Ivan Condori Leandro, Dmitry S Lebedev, Lubov B Mitrofanova, Evgeny N Mikhaylov

Institution: Federal Almazov North-West Medical Research Centre

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $815