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

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Abstract

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.

Original languageEnglish
Pages (from-to)31-37
Number of pages7
JournalYonsei medical journal
Volume56
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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Sick Sinus Syndrome
Atrial Flutter
Catheter Ablation
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Song, Changho ; Jin, Moo Nyun ; Lee, Jung Hee ; Kim, In Soo ; Uhm, Jae Sun ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung. / Predictors of sick sinus syndrome in patients after successful radiofrequency catheter ablation of atrial flutter. In: Yonsei medical journal. 2015 ; Vol. 56, No. 1. pp. 31-37.
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title = "Predictors of sick sinus syndrome in patients after successful radiofrequency catheter ablation of atrial flutter",
abstract = "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.",
author = "Changho Song and Jin, {Moo Nyun} and Lee, {Jung Hee} and Kim, {In Soo} and Uhm, {Jae Sun} and Pak, {Hui Nam} and Lee, {Moon Hyoung} and Boyoung Joung",
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Predictors of sick sinus syndrome in patients after successful radiofrequency catheter ablation of atrial flutter. / Song, Changho; Jin, Moo Nyun; Lee, Jung Hee; Kim, In Soo; Uhm, Jae Sun; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.

In: Yonsei medical journal, Vol. 56, No. 1, 01.01.2015, p. 31-37.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of sick sinus syndrome in patients after successful radiofrequency catheter ablation of atrial flutter

AU - Song, Changho

AU - Jin, Moo Nyun

AU - Lee, Jung Hee

AU - Kim, In Soo

AU - Uhm, Jae Sun

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

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N2 - 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.

AB - 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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