Long-Term Outcomes Post-AF Ablation in Tachy-Brady Syndrome

Strategic Insights -

Research has unveiled new data on Heart Disorders and Diseases - Atrial Fibrillation, specifically focusing on the long-term outcomes post-ablation in patients with tachy-brady syndrome (TBS). A study published in the Journal of Cardiovascular Electrophysiology found that among 3,440 patients who underwent atrial fibrillation (AF) ablation, 111 (3.2%) had TBS, with 54 (49%) having a permanent pacemaker (PPM) at index ablation. The study aimed to investigate the impact of PPM status on long-term outcomes post-ablation.

Key Takeaways:

  • The study included 3,440 patients who underwent AF ablation, with 111 (3.2%) having TBS.
  • Among those with TBS, 54 (49%) had a PPM at index ablation, while 26 (46%) of those without a PPM required delayed PPM implantation.
  • The composite failure rates were similar between PPM and no-PPM groups at 12 months (42% vs. 40%) and at last follow-up (44% vs. 47%).
  • However, hospitalization was significantly higher in the PPM group compared to no-PPM (85% vs. 62%).
  • Subgroup analysis revealed that delayed PPM patients had higher failure rates at 12 months (65% vs. 42%) and at last follow-up (73% vs. 44%).
  • Delayed PPM implantation was associated with higher failure and more hospitalizations, suggesting earlier or concurrent PPM may benefit selected patients.
  • The study concluded that larger prospective studies are needed to define predictors and optimize management.

Statistics:

  • Among 3,440 patients who underwent AF ablation, 3.2% (111 patients) had TBS.
  • 54 (49%) of those with TBS had a PPM at index ablation.
  • 26 (46%) of those without a PPM required delayed PPM implantation.
  • Composite failure rates at 12 months: 42% (PPM group) vs. 40% (no-PPM group).
  • Composite failure rates at last follow-up: 44% (PPM group) vs. 47% (no-PPM group).
  • Hospitalization rate: 85% (PPM group) vs. 62% (no-PPM group).
  • Delayed PPM patients had higher failure rates: 65% at 12 months vs. 42% and 73% at last follow-up vs. 44%.
  • Delayed PPM implantation was associated with higher failure (65% vs. 42%) and more hospitalizations (69% vs. 54%).

Sources:

  • NewsRx. Data from Cassie Wang et al Provide New Insights into Atrial Fibrillation (Does a Pacemaker Make a Difference? Long-Term Outcomes Post-AF Ablation in Tachy-Brady Syndrome). Medical Devices & Surgical Technology Week. November 2, 2025; p 154.
  • Wang C, Lin KY, Ho B, Hathaway E, Zhang-Sun J, Huda S, Patsiou V, Coleman K, Epstein LM, Mountantonakis S. Does a Pacemaker Make a Difference? Long-Term Outcomes Post-AF Ablation in Tachy-Brady Syndrome. Journal of Cardiovascular Electrophysiology, 2025.
  • Journal of Cardiovascular Electrophysiology. Wiley-Blackwell. Available from: onlinelibrary.wiley.com/journal/10.1111/(ISSN)1540-8167.