Changes in Renal Function in Patients with Recurrence of Atrial Arrhythmia after an Initial Catheter Ablation.

Youmei Shen,Weizhu Ju,Chang Cui,Minglong Chen,Kai Gu,Mingfang Li,Gang Yang,Hongwu Chen,Fengxiang Zhang

doi:10.1155/2022/6923377

Abstract

Background Impaired renal function and atrial fibrillation (AF) can form a vicious cycle. Although there have been reports on improved renal function in patients who undergo successful AF ablation, renal function in patients with recurrence of AF has not been studied separately. We explored the changes in renal function in recurrent AF patients after catheter ablation with mild renal dysfunction and the influencing factors. Methods We retrospectively recruited nonvalvular AF (NVAF) patients with mildly impaired renal function admitted for catheter ablation and readmitted due to recurrence of AF. The estimated glomerular filtration rate (eGFR) was calculated before the index procedure and during readmission. △eGFR was defined as the difference between eGFR readmission and eGFR baseline. The same calculation applied for △CHA2DS2-VASc score. The primary endpoint was improved renal function (△eGFR >0) after AF catheter ablation in patients with atrial arrhythmia recurrence. Results A total of 132 NVAF patients were included in this study. The mean eGFR at readmission was significantly increased compared with the eGFR at baseline before the index ablation procedure (81.5 ± 1.1 vs. 78.0 ± 0.7 ml/min/1.73 m2, P < 0.001). The multivariable Cox regression analysis showed that a lower △CHA2DS2-VASc score (HR: 0.42, P=0.003) and paroxysmal recurrent atrial arrhythmia (HR: 2.97, P=0.001) were associated with better renal function. Conclusion In NVAF patients with mildly impaired renal function, even those with recurrence after the initial catheter ablation, we observed improvements in renal function, which was associated with a lower △CHA2DS2-VASc score and paroxysmal recurrent arrhythmia.

Highlights

Atrial fibrillation (AF) is one of the most common arrhythmias in adults [1]
Additional selection criteria were atrial fibrillation (AF) catheter ablation performed during the 1st admission and rehospitalization due to AF recurrence and mildly impaired renal function at the 1st admission. e exclusion criteria were as follows: less than 3 months between the two admissions, and diagnosis of chronic kidney disease before the index AF catheter ablation
Between January 2012 and June 2019, a total of 332 patients were admitted to e First Affiliated Hospital of Nanjing Medical University for AF catheter ablation and readmitted due to recurrence of AF

Summary

Introduction

Atrial fibrillation (AF) is one of the most common arrhythmias in adults [1]. As a degenerative disease, AF is expected to be a growing health burden with the changing demographics and increased life expectancy across the globe [2,3,4]. Successful sinus rhythm restoration through CA has been known to be associated with reduced heart failure or death and improved cognitive function, quality of life, and renal function [12, 18,19,20]. E primary endpoint was improved renal function (△eGFR >0) after AF catheter ablation in patients with atrial arrhythmia recurrence. E multivariable Cox regression analysis showed that a lower △CHA2DS2-VASc score (HR: 0.42, P 0.003) and paroxysmal recurrent atrial arrhythmia (HR: 2.97, P 0.001) were associated with better renal function. In NVAF patients with mildly impaired renal function, even those with recurrence after the initial catheter ablation, we observed improvements in renal function, which was associated with a lower △CHA2DS2-VASc score and paroxysmal recurrent arrhythmia

Methods

Results

Conclusion