Pacing the atria at alternative sites may have value in preventing atrial fibrillation but the available data so far fails to prove this point. This may be explained by inadequate lead positioning. Improvement in lead placement can now be achieved by use of advanced imaging techniques such as intracardiac echocardiography. Further studies are required in order to demonstrate the potential benefit that, for example, Bachmann's bundle stimulation should offer in atrial arrhythmia prevention.

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European Heart Journal Supplements
Erasmus MC: University Medical Center Rotterdam

Szili-Török, T., Jordaens, L., & Sutton, R. (2007). Alternative pacing sites at the atrial level. European Heart Journal Supplements, 9(I). doi:10.1093/eurheartj/sum065