Sinus Node Dysfunction after Successful Atrial Flutter Ablation during Follow-Up: Clinical Characteristics and Predictors

Guan Yi Li, Fa Po Chung*, Tze Fan Chao, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Jo Nan Liao, Ting Yung Chang, Ling Kuo, Cheng I. Wu, Chih Min Liu, Shin Huei Liu, Wen Han Cheng, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Identification of sinus node dysfunction (SND) before termination of persistent AFL by catheter ablation (CA) is challenging. This study aimed to investigate the characteristics and predictors of acute and delayed SND after AFL ablation. We retrospectively enrolled 221 patients undergoing CA of persistent AFL in a tertiary referral center. Patients with SND who required a temporary pacemaker (TPM) after termination of AFL or a permanent pacemaker (PPM) during follow-up were identified. Acute SND requiring a TPM was found in 14 of 221 (6.3%) patients following successful termination of AFL. A total of 10 of the 14 patients (71.4%) recovered from acute SND. An additional 11 (5%) patients presenting with delayed SND required a PPM during follow-up, including 4 patients recovering from acute SND. Of these, 9 of these 11 patients (81.8%) underwent PPM implantation within 1 year after the ablation. In multivariable analysis, female gender and a history of hypothyroidism were associated with the requirement for a TPM following termination of persistent AFL, while older age and a history of hypothyroidism predicted PPM implantation. This study concluded that the majority of patients with acute SND still require a PPM implantation despite the initial improvement. Therefore, it is reasonable to monitor the patients closely for at least one year after AFL ablation.

Original languageEnglish
Article number3212
JournalJournal of Clinical Medicine
Issue number11
StatePublished - 1 Jun 2022


  • atrial flutter
  • catheter ablation
  • permanent pacemaker
  • sinus node dysfunction
  • temporary pacemaker


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