Sinus Node Dysfunction after Catheter Ablation of Persistent Atrial Fibrillation: The Incidence and Clinical Characteristics

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Introduction: Sinus node dysfunction (SND) and atrial fibrillation (AF) often coexist. In patients with persistent AF, restoration of sinus rhythm by catheter ablation may unmask SND, thereby requiring pacemaker therapy after the ablation. However, the incidence of SND after catheter ablation of persistent AF is unknown. Methods: Seven hundred-forty consecutive patients (634 males, 60±10 years) who underwent ablation for persistent or longstanding persistent AF from 2008 to 2010 at our institute were studied. SND after the ablation which required pacemaker implantation during 6 months follow-up was determined. Results: Seven patients (1%) underwent pacemaker implantation for SND at median of 28.5 days after ablation. There was no significant difference between patients with SND and controls in age (p=0.14), left atrial diameter (p=0.43), continuous AF duration (p=0.52). Ablation of the right atrium was performed in 43% of patients with SND compared with 16% of controls (p=0.09). Proportion of female (SND: 57%, controls: 14%; p=0.01), height (1.60±0.1 m vs 1.69±0.08 m, p=0.01), body weight (59±12 kg vs 70±11 kg, p=0.01) significantly differed between patients with SND and controls. Conclusion: Sinus node dysfunction after catheter ablation of persistent AF occurred in 1% of patients. These patients were characterized by female, shorter height and smaller body weight.
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