Korean Circulation Journal

  • 제50권4호
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  • Pages.346-357
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  • 2020
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Permanent Pacemaker Implantations after Catheter Ablation in Patients with Atrial Fibrillation Associated with Underlying Sinus Node Dysfunction

  • Hwang, Tae Hyun (Department of Cardiology, Yonsei University Health System) ;
  • Yu, Hee Tae (Department of Cardiology, Yonsei University Health System) ;
  • Kim, Tae-Hoon (Department of Cardiology, Yonsei University Health System) ;
  • Uhm, Jae-Sun (Department of Cardiology, Yonsei University Health System) ;
  • Kim, Jong-Youn (Department of Cardiology, Yonsei University Health System) ;
  • Joung, Boyoung (Department of Cardiology, Yonsei University Health System) ;
  • Lee, Moon-Hyoung (Department of Cardiology, Yonsei University Health System) ;
  • Pak, Hui-Nam (Department of Cardiology, Yonsei University Health System)
  • 투고 : 2019.08.20
  • 심사 : 2019.11.19
  • 발행 : 2020.05.31
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: The objective of this study was to evaluate the long-term clinical outcomes and the incidence of permanent pacemaker implantation after catheter ablation in patients with of atrial fibrillation (AF) and sinus node dysfunction (SND). Methods: Among 3,068 total consecutive patients who underwent AF catheter ablation (AFCA), this study included 222 (9.5%; men 53.2%, 63.7±9.2 years of age, 81.5% paroxysmal AF) with underlying SND and a regular rhythm follow-up. We analyzed the rhythm outcomes, changes in the mean heart rate or heart rate variability, and permanent pacemaker implantation rate. Results: During 47.5±28.8 months of follow-up, 25 (11.3%) patients received pacemaker implantations due to symptomatic SND. More than half (56.0%, 14/25) underwent a pacemaker implantation within 3 months of the AFCA, and the annual pacemaker implantation rate was 2.0% afterwards. Both the early (68.0% vs. 31.0%, p<0.001) and clinical AF recurrence (68.0% vs. 32.5%, p=0.001) rates and continuous antiarrhythmic drug use after 3 months (44.0% vs. 24.4%, p=0.036) were significantly higher in patients requiring pacemaker implantations than those that did not. An anterior linear ablation (odds ratio [OR], 9.37 [3.03–28.9]; p<0.001) and the E/Em (OR, 1.15 [1.02–1.28]; p=0.018) were independently associated with permanent pacemaker implantations after AFCA in patients with AF and SND. Conclusions: After AFCA in patients with AF and SND, 1 of 9 patients needed a pacemaker implantation and half needed implantations within 3 months. The AF recurrence rate was significantly higher in those who required pacemaker implantations after the AFCA.

키워드

과제정보

We thank Mr. John Martin for his linguistic assistance.

참고문헌

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피인용 문헌

  1. Atrial High-Rate Event Incidence and Predictors in Patients With Permanent Pacemaker Implantation vol.8, 2021, https://doi.org/10.3389/fcvm.2021.728885