Leier and colleagues showed that prolonged atrial conduction was a predisposing factor for development of atrial flutter as early as 1978.
Kumagai and colleagues used multisite mapping studies confirming findings of a previous study by Ogawa and colleagues. They concluded that the mechanism of atrial arrhythmias was indeed aberrant impulse conduction between the atria along interatrial pathways, mainly the BB. Duytschaever and colleagues then successfully reproduced this mechanism in animal studies. In another series, Giudici and colleagues investigated 21 patients with uncontrolled atrial fibrillation who underwent atrioventricular nodal ablation and permanent pacing. They showed that when the leads were placed in the BB, atrial conduction times were decreased.