Key result
Catheter ablation spares ~60% of elderly AF patients with SSS from needing a pacemaker.
Why the study?
In patients with AF and concomitant sinus node disease, initial treatment with catheter ablation aimed at restoring sinus rhythm may offer an alternative to pacemaker implantation.
Does catheter ablation prevent the need for pacemaker implantation in elderly patients with atrial fibrillation and symptomatic sick sinus syndrome?
Does catheter ablation prevent the need for pacemaker implantation in elderly patients with atrial fibrillation and symptomatic sick sinus syndrome?
Catheter ablation for atrial fibrillation in elderly patients with sick sinus syndrome may not reliably prevent the need for pacemaker implantation, which was still required in 40% of cases.
Answers are grounded in this paper and cite their sources.
May not obviate pacemakers despite AF ablation in elderly SSS; leaves open need for controlled trials.
In patients with atrial fibrillation (AF), sinus node disease (SND) represents a potentially reversible concomitant condition. Initial treatment with catheter ablation (CA) aimed at restoration of sinus rhythm may provide an alternative to pacemaker implantation. In this case series, 15 elderly patients (>65 years) with AF and SND underwent CA, with follow‐up monitoring provided by implantable loop recorders (ILR). Despite CA of AF, pacemaker implantation was necessary in 40% of patients during a mean follow‐up period of 37 months.
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Benachi et al. (2026) studied this question. Catheter ablation in elderly AF patients with sick sinus syndrome prevented pacemaker implantation in 60%, with 40% still needing a pacemaker over 37 months follow-up.
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