title: Impact of Catheter Ablation for Paroxysmal Atrial Fibrillation in Patients With Sick Sinus Syndrome　- Important Role of Non-Pulmonary Vein Foci.
abstract: BACKGROUND
  The clinical efficacy of catheter ablation (CA) for paroxysmal atrial fibrillation (PAF) in patients with sick sinus syndrome (SSS) and the mechanism and predictors of recurrence are not yet completely elucidated.
  
  
  RESULTS
  Of 963 consecutive patients who underwent PAF ablation during the study period, a total of 108 patients with SSS (SSS group) and 108 matched controls without SSS (non-SSS group) were followed up. During the follow-up period (mean, 32.8±17.5 months), the SSS group had significantly higher AF recurrence rate since the last procedure than the non-SSS group (26.9% vs. 12.0%; P=0.02). The SSS group had significantly higher prevalence of non-pulmonary vein (non-PV) foci than the non-SSS group (25.9% vs. 13.9%; P=0.027). On multivariate analysis congestive heart failure (HR, 13.7; 95% CI: 1.57-119; P=0.02) and non-PV foci (HR, 5.75; 95% CI: 1.69-19.6; P=0.005) were independent predictors of recurrence following CA in the SSS group. In the SSS group, 88 patients had bradycardia-tachycardia syndrome without prior permanent pacemaker implantation. Of these, 6 required pacemaker implantation because of AF and sinus pause recurrence.
  
  
  CONCLUSIONS
  Patients with SSS are at higher risk of AF recurrence after CA. Non-PV foci are associated with AF recurrence following PAF with SSS.
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Masato
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamaji
authors.forename: Yoshimori
authors.initials: Y
authors.lastname: An
authors.forename: Michio
authors.initials: M
authors.lastname: Nagashima
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hiroshima
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ohe
authors.forename: Yu
authors.initials: Y
authors.lastname: Makihara
authors.forename: Kennosuke
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Goya
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D012804:Sick Sinus Syndrome / Q000503:physiopathology / Q000601:surgery