Abstract
BackgroundThere is a controversy as to whether catheter ablation should be the first-line therapy for tachycardia-bradycardia syndrome (TBS) in patients with atrial fibrillation (AF).MethodsWe aimed to investigate long-term clinical outcomes of catheter ablation in patients with TBS and AF. Among 145 consecutive patients who underwent catheter ablation of AF with TBS, 121 patients were studied.ResultsAmong 121 patients, 11 (9.1%) received implantation of a permanent pacemaker during a mean 21 months after ablation. Length of pause on termination of AF was significantly greater in patients who received pacemaker implantation after ablation than those who underwent ablation only (7.9 ± 3.5 vs. 5.1 ± 2.1 s, p < 0.001). Using a multivariate model, a long pause of 6.3 s or longer after termination of AF was associated with the requirement to implant a permanent pacemaker after ablation (HR 1.332, 95% CI 1.115-1.591, p = 0.002).ConclusionThis study suggests that, in patients with AF predisposing to TBS, long pause on termination of AF predicts the need to implant a permanent pacemaker after catheter ablation.
Highlights
There is a controversy as to whether catheter ablation should be the first-line therapy for tachycardiabradycardia syndrome (TBS) in patients with atrial fibrillation (AF)
There was no significant difference of atrial tachyarrhythmia recurrence between patients with triggers and those with no trigger (17.8% vs. 20.8%, log-rank test p = 0.559, Additional file 1: Figure S1)
There was no significant difference of atrial tachyarrhythmia recurrence between patients with pulmonary vein (PV) trigger and those with non-PV trigger (18.6% vs. 14.3%, log-rank test p = 0.817, Additional file 2: Figure S2)
Summary
There is a controversy as to whether catheter ablation should be the first-line therapy for tachycardiabradycardia syndrome (TBS) in patients with atrial fibrillation (AF). Tachycardia-bradycardia syndrome (TBS) is literally a two-fold disease that is characterized by prolonged sinus pause on termination of atrial tachyarrhythmias, including atrial fibrillation (AF). Implantation of a permanent pacemaker plus antiarrhythmic drug (AAD) prescription is the mainstay therapy for patients with TBS due to sinus pause or its aggravation on AAD [1]. Long term follow-up data are needed because some populations of patients are likely to have intrinsic sinus node dysfunction (SND) even in the clinical setting of TBS, and SND can gradually progress in those patients who
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
