International heart journal · 2007
Pulmonary vein isolation for atrial fibrillation in patients with paroxysmal atrial fibrillation and prolonged sinus pause.
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Ohkubo Kimie, Watanabe Ichiro, Okumura Yasuo, Ashino Sonoko, Kofune Masayoshi, Hashimoto Kenichi, Shindo Atsushi, Sugimura Hidezou, Nakai Toshiko, Kasamaki Yuji, Saito Satoshi
Аннотация
BACKGROUND: Symptomatic prolonged sinus pauses upon termination of atrial fibrillation (AF) are an indication for pacemaker implantation.
METHODS AND RESULTS: We evaluated the clinical outcomes of 4 patients who showed prolonged sinus pauses (> 2 seconds) upon termination of AF and thus underwent ablation. The ablative procedure included pulmonary vein isolation, superior vena cava isolation, and cavo-tricuspid isthmus ablation. Twenty-four-hour ambulatory electro-cardiogram monitoring was performed before and 1 month after ablation. The maximum sinus pause decreased from 4.5 +/- 2.1 seconds before ablation to 1.7 +/- 0.2 seconds after ablation. Sinus pauses > 2.0 seconds disappeared after ablation in all 4 patients. Minimum heart rate increased from 35.0 +/- 8.1 beats/minute before ablation to 52 +/- 6.7 beats/minute after ablation. The number of heart beats in 24 hours did not change significantly after ablation.
CONCLUSION: Prolonged sinus pauses after paroxysmal AF may result from depressed sinus node function, which can be eliminated by curative ablation of AF.
METHODS AND RESULTS: We evaluated the clinical outcomes of 4 patients who showed prolonged sinus pauses (> 2 seconds) upon termination of AF and thus underwent ablation. The ablative procedure included pulmonary vein isolation, superior vena cava isolation, and cavo-tricuspid isthmus ablation. Twenty-four-hour ambulatory electro-cardiogram monitoring was performed before and 1 month after ablation. The maximum sinus pause decreased from 4.5 +/- 2.1 seconds before ablation to 1.7 +/- 0.2 seconds after ablation. Sinus pauses > 2.0 seconds disappeared after ablation in all 4 patients. Minimum heart rate increased from 35.0 +/- 8.1 beats/minute before ablation to 52 +/- 6.7 beats/minute after ablation. The number of heart beats in 24 hours did not change significantly after ablation.
CONCLUSION: Prolonged sinus pauses after paroxysmal AF may result from depressed sinus node function, which can be eliminated by curative ablation of AF.