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Predictors of sick sinus syndrome in patients after successful radiofrequency catheter ablation of atrial flutter

 Changho Song  ;  Moo-Nyun Jin  ;  Jung-Hee Lee  ;  In-Soo Kim  ;  Jae-Sun Uhm  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Boyoung Joung 
 YONSEI MEDICAL JOURNAL, Vol.56(1) : 31-37, 2015 
Journal Title
Issue Date
Atrial Flutter/physiopathology ; Atrial Flutter/surgery* ; Catheter Ablation/adverse effects* ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Risk Factors ; Sick Sinus Syndrome/etiology* ; Sick Sinus Syndrome/physiopathology ; Treatment Outcome
Atrial flutter ; ablation ; sick sinus syndrome
PURPOSE: The identification of sick sinus syndrome (SSS) in patients with atrial flutter (AFL) is difficult before the termination of AFL. This study investigated the patient characteristics used in predicting a high risk of SSS after AFL ablation.
MATERIALS AND METHODS: Out of 339 consecutive patients who had undergone radiofrequency ablation for AFL from 1991 to 2012, 27 (8%) had SSS (SSS group). We compared the clinical characteristics of patients with and without SSS (n=312, no-SSS group).
RESULTS: The SSS group was more likely to have a lower body mass index (SSS: 22.5±3.2; no-SSS: 24.0±3.0 kg/m²; p=0.02), a history of atrial septal defects (ASD; SSS: 19%; no-SSS: 6%; p=0.01), a history of coronary artery bypass graft surgery (CABG; SSS: 11%; no-SSS: 2%; p=0.002), and a longer flutter cycle length (CL; SSS: 262.3±39.2; no-SSS: 243.0±40; p=0.02) than the no-SSS group. In multivariate analysis, a history of ASD [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.2-11.4, p=0.02] and CABG (7.1, 95% CI 1.5-32.8, p=0.01) as well as longer flutter CL (1.1, 95% CI 1.0-1.2, p=0.04) were independent risk factors for SSS.
CONCLUSION: A history of ASD and CABG as well as longer flutter CL increased the risk of SSS after AFL ablation. While half of the patients with SSS after AFL ablation experienced transient SSS, heart failure was associated with irreversible SSS.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Song, Chang Ho(송창호)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Jung Hee(이중희)
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Jin, Moo Nyun(진무년) ORCID logo https://orcid.org/0000-0001-5482-4441
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