Acute Sinus Node Dysfunction After Atrial Ablation: Incidence, Risk Factors and Management

Ammar Killu1, Erin Fender1, Abhishek Deshmukh1, Thomas Munger1, Philip Araoz2, Peter Brady1, Douglas Packer1, Paul Friedman1, Samuel Asirvatham1, Peter Noseworthy1, Siva Mulpuru1
1 Cardiovascular Diseases, Mayo Clinic, USA
2 Cardiovascular Radiology, Mayo Clinic, USA

Aim: Many patients with atrial fibrillation (AF) or flutter (AFL) have concomitant sinus node dysfunction (SND). Ablation may result in injury to the sinus node complex or its blood supply resulting in sinus arrest and need for temporary pacing. We sought to characterize patients who develop acute sinus node dysfunction (ASND) during or immediately after catheter ablation for AF/AFL.

Methods and Results: We performed a retrospective analysis AF/AFL ablation patients between 1/1/2010-2/28/2015 to characterize those who required temporary pacemaker implantation due to ASND (sinus arrest, sinus bradycardia 50% of the time.

Conclusion: ASND is a rare complication of atrial ablation. It may be more common when ablation at the SVC ostium is performed and may necessitate permanent pacemaker implantation.