A case of transient tachy-bradycardia syndrome following combined atrial fibrillation ablation and left atrial appendage closure.

Atrial fibrillation (AF) and atrial flutter (AFL) are common arrhythmias, with incidence increasing with age. Catheter ablation and left atrial appendage closure (LAAC) are guideline-recommended treatments for patient with AF and high thromboembolic risk of stroke. We report the case of a patient with paroxysmal AF/AFL at high thromboembolic risk who developed paroxysmal rapid AF with sinus arrest following combined pulmonary vein isolation (PVI) and LAAC. Notably, both the arrhythmia and sinus node dysfunction gradually resolved over three months without pacemaker implantation. We propose that a watchful waiting strategy may be appropriate in similar clinical scenarios.