Permanent pacemaker implantations after catheter ablation in patients with atrial fibrillation associated with underlying sinus node dysfunction

Tae Hyun Hwang, Hee Tae Yu, Tae Hoon Kim, Jae Sun Uhm, Jong Youn Kim, Boyoung Joung, Moon Hyoung Lee, Hui Nam Pak

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)346-357
Number of pages12
JournalKorean Circulation Journal
Issue number4
Publication statusPublished - 2020

Bibliographical note

Funding Information:
This work was supported by a grant (HI18C0070) and (HI19C0114) from the Ministry of Health and Welfare and a grant (NRF-2017R1A2B4003983) from the Basic Science Research Program run by the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science, ICT & Future Planning (MSIP).

Publisher Copyright:
Copyright © 2020. The Korean Society of Cardiology

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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