Prospective Cohort Study of Bachmann Bundle Versus Right Atrial Appendage Pacing: Impact on Atrial Cardiomyopathy Evaluated by Echocardiographic Parameters and Clinical Outcome

The goal of this observational study is to evaluate the impact of different atrial pacing sites-Bachmann's bundle pacing versus right atrial appendage pacing-on the development and progression of atrial cardiomyopathy in patients diagnosed with sick sinus syndrome who are undergoing permanent pacemaker implantation.

Inclusion Criteria: * Patients aged 19 years or older * Patients diagnosed with sick sinus syndrome who are scheduled for de novo implantation of a permanent pacemaker or permanent implantable cardioverter-defibrillator * Patients or their legal representatives who voluntarily consent to the access of medical records and study data throughout the entire research period Exclusion Criteria: * Patients with persistent or permanent AF * Patients with a life expectancy of less than one year due to other comorbidities * Pregnant or breastfeeding women * Patients who refuse active treatment