title: Pulmonary vein isolation for atrial fibrillation in patients with paroxysmal atrial fibrillation and prolonged sinus pause.
abstract: BACKGROUND
  Symptomatic prolonged sinus pauses upon termination of atrial fibrillation (AF) are an indication for pacemaker implantation.
  
  
  RESULTS
  We evaluated the clinical outcomes of 4 patients who showed prolonged sinus pauses (> 2 seconds) upon termination of AF and thus underwent ablation. The ablative procedure included pulmonary vein isolation, superior vena cava isolation, and cavo-tricuspid isthmus ablation. Twenty-four-hour ambulatory electro-cardiogram monitoring was performed before and 1 month after ablation. The maximum sinus pause decreased from 4.5 +/- 2.1 seconds before ablation to 1.7 +/- 0.2 seconds after ablation. Sinus pauses > 2.0 seconds disappeared after ablation in all 4 patients. Minimum heart rate increased from 35.0 +/- 8.1 beats/minute before ablation to 52 +/- 6.7 beats/minute after ablation. The number of heart beats in 24 hours did not change significantly after ablation.
  
  
  CONCLUSIONS
  Prolonged sinus pauses after paroxysmal AF may result from depressed sinus node function, which can be eliminated by curative ablation of AF.
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Kimie
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Sonoko
authors.initials: S
authors.lastname: Ashino
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kofune
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shindo
authors.forename: Hidezou
authors.initials: H
authors.lastname: Sugimura
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011667:Pulmonary Veins; D012804:Sick Sinus Syndrome / Q000150:complications / Q000601:surgery*