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April 13, 2026Journal of Cardiovascular Electrophysiology

SSS was associated with higher odds of requiring PVI-plus ablation (OR 2.087; 95% CI 1.146-3.787), but AF recurrence at 36 months did not differ significantly between SSS and non-SSS patients (42% vs. 31%; sHR 1.314; 95% CI 0.812-2.127).

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Why the study?

Does the presence of sick sinus syndrome affect procedural complexity and long-term atrial fibrillation recurrence in patients undergoing initial radiofrequency ablation?

Population

676 patients undergoing initial radiofrequency catheter ablation for atrial fibrillation, including 53 with…

Comparison

Initial radiofrequency catheter ablation for… vs Initial radiofrequency catheter ablation for…

Design

Cohort

Follow-up

36 months

Authors

RHRikako HorieHKHiroshi KawakamiKKK. Kurokawa

Discussion

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Overview

Patients with sick sinus syndrome undergoing atrial fibrillation ablation require more complex procedures for concomitant arrhythmias but achieve comparable long-term freedom from AF recurrence compared to patients without sick sinus syndrome.

Key Points

  • The study evaluates outcomes of AF ablation in patients with sick sinus syndrome compared to those without SSS.
  • Conducted a retrospective review of 676 patients who underwent initial radiofrequency AF ablation.
  • Compared PVI- plus ablation strategies between patients with SSS and those without SSS using propensity score matching.
  • Examined rates of AF recurrence and the need for permanent pacemaker implantation.
  • PVI-plus ablation was significantly more common in SSS patients (47%) compared to non-SSS patients (29%).
  • Higher odds of receiving PVI-plus ablation were found for patients with SSS (odds ratio 2.087).
  • AF recurrence at 36 months was similar between SSS and non-SSS patients (42% vs. 31%).

Structured PICO

Does the presence of sick sinus syndrome affect procedural complexity and long-term atrial fibrillation recurrence in patients undergoing initial radiofrequency ablation?

P
Population
676 patients undergoing initial radiofrequency catheter ablation for atrial fibrillation, including 53 with sick sinus syndrome (SSS) and 623 without SSS. A 1:5 propensity score-matched cohort included 53 SSS and 265 non-SSS patients.
I
Intervention
Initial radiofrequency catheter ablation for atrial fibrillation in patients with sick sinus syndrome (SSS)
C
Comparator
Initial radiofrequency catheter ablation for atrial fibrillation in patients without sick sinus syndrome (non-SSS)
O
Outcome
Procedural complexity (frequency of PVI-plus ablation, defined as ablation targeting the cavotricuspid isthmus, non-pulmonary vein foci, or atrial tachycardia) and atrial fibrillation recurrence at 36 monthshard clinical

Patients with sick sinus syndrome undergoing atrial fibrillation ablation require more complex procedures for concomitant arrhythmias but achieve comparable long-term freedom from AF recurrence compared to patients without sick sinus syndrome.

Cite This Study

Horie et al. (2026) studied this question.

synapsesocial.com/papers/69dc892e3afacbeac03eaf3dhttps://doi.org/10.1111/jce.70338
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Also Consider

Synapse has enriched one closely related paper. Consider it for comparative context:

  1. 1Approaches to Catheter Ablation for Persistent Atrial Fibrillation2015 · 2,345 citations