Bachmann's bundle that area. The normal cardiac rhythm originates in the sinoatrial node, which is located in the right atrium near the superior vena cava. From there, the electrical activation spreads throughout the right atrium. There are at least four different locations where the activation can pass to the left atrium. Apart from Bachmann's bundle these are the anterior interatrial septum, posterior interatrial septum, and the coronary sinus. Because it originates close to the sinoatrial node and consists of long parallel fibers, Bachmann's bundle is, during sinus rhythm, the first of these connections to activate the left atrium. Bachmann's bundle In the
Artificial cardiac pacemaker which is the mode of choice when atrioventricular conduction is intact but the natural pacemaker the sinoatrial node is unreliable – sinus node disease (SND) or sick sinus syndrome. Where the problem is atrioventricular block (AVB) the pacemaker is required to detect (sense) the atrial beat and after a normal delay (0.1–0.2 seconds) trigger a ventricular beat, unless it has already happened – this is VDD mode and can be achieved with a single pacing lead with electrodes in the right atrium (to sense) and ventricle (to sense and pace). These modes AAIR and VDD are unusual in the US