Objectives: This study aimed to investigate incidence and risk factors for permanent pacemaker implantation for sick sinus syndrome( SSS) after maze procedure.
Methods: Medical records of 59 patients who underwent maze procedure for atrial fibrillation at our hospital from 2018 to 2022 were retrospectively reviewed.
Results: Mean age was 70 years and 32 patients (54%) were male. Major cardiac procedure was mitral valve surgery in 43( 72%). Radiofrequency ablation device was used in 35( 59%) and cryoablation was used in 24 (41%). Nineteen patients (32%) required temporary pacing after surgery;7 for type Ⅰ or Ⅱ SSS, 9 for type Ⅲ SSS and 3 for bradycardiac atrial fibrillation. Of these, all the 7 patients with type Ⅰ or Ⅱ SSS regained sinus rhythm, whereas 2 with type Ⅲ SSS underwent permanent pacemaker implantation. Overall, permanent pacemaker was implanted in 3( 5%). Forty-six patients( 78%) were in sinus rhythm at the outpatient clinic after surgery.
Conclusions: Type Ⅰ or Ⅱ SSS after maze procedure is likely to resume sinus rhythm at the time of discharge whereas type Ⅲ is not. For type Ⅲ SSS after maze procedure, adequate anti-arrhythmic medication early after surgery may be required to avoid permanent pacemaker implantation.