title: Permanent sinus dysfunction after pulmonary vein isolation ablation: observations and potential mechanisms.
abstract: Although transient sinus arrest has been reported during pulmonary vein isolation (PVI), the long-term impairment of sinus node after PVI has not been described. In this report, we present a case of sinus node dysfunction necessitating a permanent pacemaker, caused during PVI. Clinical data, intracardiac electrograms, and cardiac imaging were incompatible with previous sinus node dysfunction, sinus node artery occlusion, or an ectopic atrial rhythm from the pulmonary veins. Impairment of the neural pathways connecting the ganglionated plexi of the right superior pulmonary veins with the sinus node is a possible underlying mechanism.
authors.affiliation: Department of Cardiology, "Attikon" University Hospital of Athens, Athens, Greece. Electronic address: dleftheriotis@gmail.com.
authors.forename: Dionyssios
authors.initials: D
authors.lastname: Leftheriotis
authors.affiliation: Department of Cardiology, "Attikon" University Hospital of Athens, Athens, Greece.
authors.forename: Panayota
authors.initials: P
authors.lastname: Flevari
authors.affiliation: Department of Radiology, "Attikon" University Hospital of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Mademli
authors.affiliation: Department of Cardiology, "Attikon" University Hospital of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Anastasiou-Nana
mesh_terms: D000368:Aged; D001146:Arrhythmia, Sinus / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017763:Autonomic Denervation / Q000009:adverse effects* / Q000379:methods; D001341:Autonomic Nervous System / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012849:Sinoatrial Node / Q000503:physiopathology