Abstract 10121: Predictors of Sinus Node Dysfunction in Patients After Successful Radiofrequency Catheter Ablation of Typical Atrial Flutter
Objectives: The identification of sinus node dysfunctionb (SND) in patients with atrial flutter (AFL) is difficult before the termination of AFL. This study investigated the predictors of SND in patients who had undergone successful AFL ablation.
Methods: In consecutive 329 patients who had undergone radiofrequency ablation for typical AFL from 1991 to 2012, 27 (8%) patients had SND (SND group). We compared the clinical characteristics between patients with SND and those without SND (n = 302, no-SND group).
Results: In SND group, 14 patient had transient SND with the duration of 19.9 ± 23.1 hours after AFL ablation. However, SND was not resolved permanently in 13 patients including 8 (2%) patients with permanent pacemaker implantation. SND group had the history of atrial septal defect (ASD,19%, vs. 6%, p=0.014) and coronary artery bypass graft (CABG, 11%, vs. 2%, p=0.002) more frequently than no-SND group. SND group had lower body mass index (22.5 ± 3.2 vs. 23.9 ± 3.1 kg/m2, p=0.02) and a longer flutter cycle length (FCL, 262.3 ± 39.2 vs. 242.4 ± 45.3) than no-SND group. The ventricular function was not significantly different between two groups. In multivariate analysis, the history of ASD (OR 3.60, 95% CI 1.17-11.04, p=0.025) and CABG (6.88, 95% CI 1.49-31.79, p=0.013) were the independent risk factors of SND with a longer FCL (1.11, 95% CI 1.00-1.23, p=0.039).
Conclusions: This study suggests that the history of ASD and CABG, and assessing the FCL in patients with persistent AFL could be helpful in the risk stratification of underlying sinus node dysfunction.
- © 2013 by American Heart Association, Inc.