Hypokinetic arrhythmias arising after several months from ATC for complex atrial arrhythmia (atrial fibrillation and atrial flutter).

In this article are reported hypokinetic arrhytmias (asystole or AVB 3°) arising after several months from ablation procedure that needed definitive pacemaker implantation. This event, coming in patients submitted to ablation of left atrial roof and cavotricuspid isthmus area, could be considered, primarily, complications of ablation. However, their appearance long time after the RF-TCA let us to consider them autonomic and independent events. The observation of these events opens a patho-physiological discussion in relation to current knowledge and we suggest these three hypothesis: a)“Electric remodelling as a result of ablation procedure”; b)“Development of the natural history of AF”; c)“Random observation”.