Permanent Pacemaker Implantations after Catheter Ablation in Patients with Atrial Fibrillation Associated with

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Tae Hyun Hwang1, Hee Tae Yu1, Tae Hoon Kim1

  • 1Department of Cardiology, Yonsei University Health System, Seoul, Korea.

Korean Circulation Journal
|January 22, 2020
PubMed

Insights

Approximately 1 in 9 patients with atrial fibrillation and sinus node dysfunction require pacemaker implantation after catheter ablation. Over half of these implantations occur within three months, with higher atrial fibrillation recurrence rates observed in patients needing pacemakers.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Atrial fibrillation (AF) and sinus node dysfunction (SND) often coexist.
  • Catheter ablation is a common treatment for AF.
  • The impact of AF catheter ablation on patients with underlying SND requires further investigation.

Purpose of the Study:

  • To assess long-term clinical outcomes after AF catheter ablation in patients with SND.
  • To determine the incidence of permanent pacemaker implantation in this patient group.
  • To identify factors associated with pacemaker implantation post-ablation.

Main Methods:

  • Retrospective analysis of 222 patients with AF and SND undergoing AF catheter ablation (AFCA).
  • Evaluation of rhythm outcomes, heart rate variability, and pacemaker implantation rates.
  • Follow-up duration averaged 47.5 months.

Main Results:

  • 11.3% of patients (25/222) required permanent pacemaker implantation due to symptomatic SND.
  • Over half of pacemaker implantations (56.0%) occurred within 3 months post-AFCA.
  • Patients requiring pacemakers had significantly higher AF recurrence rates and antiarrhythmic drug use.

Conclusions:

  • Permanent pacemaker implantation is a significant long-term outcome after AFCA in patients with SND.
  • Early pacemaker implantation is common, necessitating close monitoring within the first three months.
  • Higher AF recurrence rates in pacemaker recipients suggest a complex interplay between AF, SND, and ablation outcomes.
Abstract

Keywords:
Atrial fibrillationCatheter ablationPacemaker, artificialSinus node dysfunction

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