Immediate Electrophysiological Effects of Different Atrial Pacing Sites on P-Wave Characteristics
Prospective Within-Subject Evaluation of Immediate Electrophysiological Effects of Multiple Atrial Pacing Sites on Atrial Activation and P-Wave Morphology
Shanghai Tong Ren Hospital
35 participants
Mar 31, 2026
INTERVENTIONAL
Conditions
Summary
This is a prospective, single-center, non-randomized, within-subject interventional study. The purpose is to compare the immediate effects of different atrial pacing sites on atrial electrical activation, as reflected by P-wave characteristics on surface electrocardiography (ECG). During pacemaker implantation, short-term pacing will be performed sequentially at multiple predefined atrial sites, including the right atrial appendage (RAA), atrial septum, Bachmann's bundle (BB) area, and posterosuperior bundle (PSB) regions. ECG parameters will be recorded at each site to evaluate differences in P-wave duration and morphology.
Eligibility
Inclusion Criteria4
- Age ≥18 years
- Sinus rhythm at baseline
- Indication for permanent pacemaker implantation with planned atrial lead placement
- Willing and able to provide written informed consent
Exclusion Criteria8
- Long-standing persistent or permanent atrial fibrillation, or prior atrioventricular node ablation
- Prior cardiac implantable electronic device (CIED) requiring revision, replacement, or upgrade
- Indication for implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D)
- Significant valvular heart disease, cardiomyopathy, or prior cardiac surgery
- Angina or acute myocardial infarction within 3 months before enrollment
- Chronic use of antiarrhythmic drugs
- Severe hepatic or renal dysfunction, or other serious systemic diseases
- Participation in another clinical study that may interfere with the objectives of this study
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Interventions
Short-time atrial pacing at right atrial appendage (RAA), atrial septum, Bachmann's bundle (BB) area, and posterosuperior bundle (PSB) regions (high and low levels) during regular pacemaker implantation procedures are applied for acute electrocardiogram and echocardiogram testings.
Locations(2)
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NCT07603648