Kim DH, et al. - Researchers investigated if catheter ablation should be first-line therapy for tachycardia-bradycardia syndrome (TBS) in patients with atrial fibrillation (AF). They analyzed the long-term clinical outcomes of catheter ablation in patients with TBS and AF. They noted that, during a mean 21 months after ablation, a permanent pacemaker was implanted in 11 of 121 patients. Relative to patients who underwent ablation only, a significantly greater length of pause on termination of AF was noted in those who received pacemaker implantation after ablation. Following catheter ablation, the need to implant a permanent pacemaker was predicted by long pause on termination of AF in patients with AF predisposing to TBS.