Pulmonary Vein Isolation for Atrial Fibrillation in Patients with Paroxysmal Atrial Fibrillation and Sick Sinus Syndrome

Abstract

Background: Although patients with paroxysmal atrial fibrillation (PAF) and prolonged sinus pauses (bradycardia-tachycardia syndrome [BTS]) are generally treated by implantation of a permanent pacemaker, catheter ablation has been reported to be a curative therapy for BTS without pacemaker implantation. The purpose of this study was to clarify the potential role of catheter ablation in patients with BTS. Methods: Ten patients with BTS who underwent pulmonary vein isolation with or without additional left atrial ablation were analyzed. Results: Four patients required additional left atrial ablation. One patient required a repeat procedure. During the 28 ± 7 months follow-up, 9 patients were AF free without pacemaker implantation, and 1 patient required pacemaker implantation because of sustained sinus bradycardia and sinus pauses without recurrence of AF. Conclusion: Catheter ablation can eliminate both AF and prolonged sinus pauses in the majority of BTS patients.