Predictors of permanent pacemaker implantation after sinus conversion of cavotricuspid isthmus-dependent atrial flutter

Autor: Juwon Kim, Sung Ho Lee, Hye Ree Kim, Tae-Wan Chung, Ji-Hoon Choi, Ju Youn Kim, Seung-Jung Park, Young Keun On, June Soo Kim, Kyoung-Min Park
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Scientific Reports, Vol 12, Iss 1, Pp 1-9 (2022)
Druh dokumentu: article
ISSN: 2045-2322
DOI: 10.1038/s41598-022-09439-8
Popis: Abstract It is unclear which factors are associated with progressive sinus node dysfunction after cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) ablation. We sought to evaluate the incidence and predictors for permanent pacemaker (PPM) implantation after CTI-dependent AFL ablation. Between January 2011 and June 2021, 353 patients underwent CTI-dependent AFL ablation were studied. During a median follow-up of 31.6 months, 30 patients (8.5%) received PPM implantation, 24 for sick sinus syndrome and 6 for atrioventricular block. In multivariable model, prior atrial fibrillation (AF) (HR 3.570; 95% CI 1.034–12.325; P = 0.044), lowest previous sinus heart rate (HR 0.942; 95% CI 0.898–0.988; P = 0.015), and left atrial volume index (LAVI) (HR 1.067; 95% CI 1.024–1.112; P = 0.002) were independently associated with PPM implantation after CTI-dependent AFL ablation. The best cut-off points for predicting PPM implantation were 60.1 ml/m2 for LAVI and 46 beats per minute for lowest previous sinus heart rate. Among the patients discharged without PPM implantation after ablation, sinus pause over three seconds at AFL termination during ablation was an independent predictor of PPM implantation (HR 17.841; 95% CI 4.626–68.807; P
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