Permanent pacemaker implantation after atrial flutter ablation

Tóm tắt

   Catheter ablation (CA) for typical atrial flutter (AFL) is well‐established and has a high success rate and adequate safety. Sinus node dysfunction (SND) can occasionally develop after the termination of long-term, persistent AFL through ablation. Since sinus node function cannot be evaluated during AFL, the preoperative prediction of underlying SND remains unexplored. In such cases, symptomatic patients with long sinus pause on ECG can require pacemaker implantation. We report a case of a 63-year-old female patient with a three-year history of atrial fibrillation and flutter, presenting with dizziness and lightheadedness. Following radiofrequency catheter ablation, her symptoms persisted. A 24-hour Holter electrocardiogram recorded atrial fibrillation with maximum sinus pause of 7.51 seconds. A permanent pacemaker was implanted, resulting in significant symptom remission. This case highlights the need for further research into identifying predictors of SND in patients undergoing catheter ablation for persistent AFL, to guide preoperative assessment and improve clinical outcomes.

DOI: 10.59715/pntjmp.4.2.23