Atrial Septal Pacing: Synchronising the Atria

Permanent transvenous atrial pacing leads have been placed traditionally in the right atrial appendage. In patients with prolonged interatrial conduction time, pacing and sensing from the right atrial appendage may produce deleterious left heart timing intervals1,2. By pacing the left atrium one could remove any uncertainties regarding interatrial conduction time and potentially achieve appropriate left-sided timing intervals. In addition, it is possible that simultaneous depolarisation of both atria would result in a decreased incidence of reentrant atrial tachyarrhythmias3–6. Previous attempts at transvenous pacing of the left atrium have involved multi-site and multi-lead systems3–6. We present our early results of single-lead, single-site simultaneous pacing of both atria from the interatrial septum which will allow optimal left-sided timing intervals and decreased dispersion of right and left atrial activation and depolarisation.