Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Arrhythmia/Electrophysiology
Impact of Catheter Ablation for Paroxysmal Atrial Fibrillation in Patients With Sick Sinus Syndrome – Important Role of Non-Pulmonary Vein Foci –
Kentaro HayashiMasato FukunagaKyohei YamajiYoshimori AnMichio NagashimaKenichi HiroshimaMasatsugu OheYu MakiharaKennosuke YamashitaKenji AndoMasashi IwabuchiMasahiko Goya
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2016 Volume 80 Issue 4 Pages 887-894

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Abstract

Background:The clinical efficacy of catheter ablation (CA) for paroxysmal atrial fibrillation (PAF) in patients with sick sinus syndrome (SSS) and the mechanism and predictors of recurrence are not yet completely elucidated.Methods and Results:Of 963 consecutive patients who underwent PAF ablation during the study period, a total of 108 patients with SSS (SSS group) and 108 matched controls without SSS (non-SSS group) were followed up. During the follow-up period (mean, 32.8±17.5 months), the SSS group had significantly higher AF recurrence rate since the last procedure than the non-SSS group (26.9% vs. 12.0%; P=0.02). The SSS group had significantly higher prevalence of non-pulmonary vein (non-PV) foci than the non-SSS group (25.9% vs. 13.9%; P=0.027). On multivariate analysis congestive heart failure (HR, 13.7; 95% CI: 1.57–119; P=0.02) and non-PV foci (HR, 5.75; 95% CI: 1.69–19.6; P=0.005) were independent predictors of recurrence following CA in the SSS group. In the SSS group, 88 patients had bradycardia-tachycardia syndrome without prior permanent pacemaker implantation. Of these, 6 required pacemaker implantation because of AF and sinus pause recurrence.Conclusions:Patients with SSS are at higher risk of AF recurrence after CA. Non-PV foci are associated with AF recurrence following PAF with SSS. (Circ J 2016; 80: 887–894)

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© 2016 THE JAPANESE CIRCULATION SOCIETY
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