Document Detail


Pulmonary vein isolation for atrial fibrillation in patients with symptomatic sinus bradycardia or pauses.
MedLine Citation:
PMID:  15250863     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Sick sinus syndrome is commonly associated with tachyarrhythmias and bradyarrhythmias that often are symptomatic. The aim of this study was to assess the effect of pulmonary vein isolation in patients with sick sinus syndrome and atrial fibrillation (AF). METHODS AND RESULTS: Three hundred fourteen consecutive patients who underwent pulmonary vein isolation between December 2000 and January 2002 were included in the study. Thirty-one patients had sick sinus syndrome, which was defined as a preprocedural history of symptomatic sinus bradycardia or pauses. Endpoints included AF recurrence, change in the frequency of sinus pauses, and symptoms of presyncope or syncope, as well as mean heart rate and percentage of atrial pacing in patients with pacemakers implanted prior to the pulmonary vein isolation. Patients had AF for an average of 6 +/- 3 years. Patients were 58 +/-8 years old and had ejection fractions of 55 +/- 4%. Sixty-one percent had implanted pacemakers. AF recurred within 6 months in 4 patients. Two had a successful second pulmonary vein isolation procedure. There were no recurrences of presyncopal events (P < 0.05) or documented sinus pauses (P < 0.05) after successful pulmonary vein isolation in the patients without permanent pacemakers. Patients with pacemakers had a 13-fold reduction in the percentage of atrial pacing (P < 0.05). Both groups showed a significant increase in average heart rates at 6-month follow-up. CONCLUSION: Cure of AF by pulmonary vein isolation helped resolve the clinical manifestations of sick sinus syndrome, suggesting that the occurrence of AF and/or the associated treatment could be partially responsible for sick sinus syndrome.
Authors:
Yaariv Khaykin; Nassir F Marrouche; David O Martin; Walid Saliba; Robert Schweikert; Mark Wexman; Brian Strunk; Salwa Beheiry; Eduardo Saad; Mandeep Bhargava; J David Burkhardt; George Joseph; Patrick Tchou; Andrea Natale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  15     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-14     Completed Date:  2004-11-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  784-9     Citation Subset:  IM    
Affiliation:
Center for Atrial Fibrillation, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Atrial Fibrillation / etiology,  physiopathology,  surgery*
Catheter Ablation
Chi-Square Distribution
Electrocardiography
Female
Humans
Male
Middle Aged
Pacemaker, Artificial*
Pulmonary Veins*
Recurrence
Sick Sinus Syndrome / complications,  physiopathology,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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