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Anatomic description of Bachmann’s Bundle and its relation to the atrial septum

2003; Elsevier BV; Volume: 91; Issue: 12 Linguagem: Inglês

10.1016/s0002-9149(03)00405-3

1879-1913

Robert Lemery, G Guiraudon, John P. Veinot,

Cardiac electrophysiology and arrhythmias

Jean George Bachmann, in 1916, reported in The American Journal of Physiology on the auricular time intervals in 12 dog experiments. 1 Bachmann J.G. The interauricular time interval. Am J Physiol. 1916; 41: 309-320 Google Scholar Bachmann hypothesized that in view of the solidarity of the auricles, a special structure may exist whose special function would be that of interauricular conduction. He described a band of muscle tissue stretching from the right auricle to the base of the left atrial appendage, acknowledging that Lewis et al 2 Lewis T. Meakins J. White P.D. The excitatory process in the dog's heart. Part I. The auricles. Phil Trans Roy Soc Lond. 1914; 205: 375-426 Crossref Google Scholar had made similar observations 2 years earlier, describing it as the interauricular band. With time, this band of tissue became known as Bachmann's bundle (BB). There are relatively few specific anatomic studies of BB. 3 Papez J.W. Heart musculature of the atria. Am J Anat. 1920; 27: 255-277 Crossref Scopus (102) Google Scholar , 4 James T.N. The connecting pathways between the sinus node and A-V node and between the right and the left atrium in the human heart. Am Heart J. 1963; 66: 498-508 Abstract Full Text PDF PubMed Scopus (280) Google Scholar , 5 Ho S.Y. Sanchez-Quintana D. Cabrera J.A. Anderson R.H. Anatomy of the left atrium implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 1999; 10: 1525-1533 Crossref PubMed Scopus (611) Google Scholar , 6 Wang K. Ho S.Y. Gibson D.G. Anderson R.H. Architecture of atrial musculature in humans. Br Heart J. 1995; 73: 559-565 Crossref PubMed Scopus (168) Google Scholar , 7 Ho S.Y. Sanchez-Quintana D. Structure of the left atrium. Eur Heart J. 2000; 2: 4-8 Google Scholar Recently, high-resolution optical mapping in sheep 8 Mansour M. Mandapati R. Berenfeld O. Chen J. Samie F.H. Jalife J. Left-to-right gradient of atrial frequencies during acute atrial fibrillation in the isolated sheep heart. Circulation. 2001; 103: 2631-2636 Crossref PubMed Scopus (322) Google Scholar and endocardial–epicardial mapping in dogs 9 Derakhchan K. Li D. Courtemanche M. Smith B. Brouillette J. Pagé P.L. Nattel S. Method for simultaneous epicardial and endocardial mapping of in vivo canine heart application to atrial conduction properties and arrhythmia mechanisms. J Cardiovasc Electrophysiol. 2001; 12: 548-555 Crossref PubMed Scopus (74) Google Scholar further supported previous work 10 Allessie M.A. Lammers W.J.E.P. Bonke F.I.M. Hollen J. Experimental evaluation of Moe's multiple wavelet hypothesis of atrial fibrillation. in: Zipes D.P. Jalife J. Cardiac Electrophysiology and Arrhythmias. Grune & Stratton, New York1985: 265-275 Google Scholar , 11 Schuessler R.B. Boineau J.P. Bromberg B.I. Hand D.E. Yamauchi S. Cox J.L. Normal and abnormal activation of the atrium. in: Zipes D.P. Jalife J. Cardiac Electrophysiology: From Cell to Bedside. 2nd ed. W. B. Saunders, Philadelphia1995: 543-562 Google Scholar on the importance of BB in the pathogenesis of atrial fibrillation. Clinical electrophysiologic reports using nonfluoroscopic mapping have demonstrated that BB provides the most important interatrial conduction pathway and may play a role in sustaining atrial fibrillation. 12 Roithinger F.X. Cheng J. SippensGroenewegen A. Lee R.J. Saxon L.A. Scheinman M.M. Lesh M.D. Use of electroanatomic mapping to delineate transseptal atrial conduction in humans. Circulation. 1999; 100: 1791-1797 Crossref PubMed Scopus (149) Google Scholar , 13 Schilling R.J. Kadish A.H. Peters N.S. Goldberger J. Davies W. Endocardial mapping of atrial fibrillation in the human right atrium using a noncontact catheter. Eur Heart J. 2000; 21: 550-564 Crossref PubMed Scopus (87) Google Scholar In view of the renewed interest and potential importance for interventions, we performed a detailed anatomic investigation of BB in human heart specimens.