TY - JOUR
T1 - Renal function after repeat catheter ablation for long-standing persistent atrial fibrillation
T2 - Low CHA2DS2-VASc score and sinus rhythm predict improved renal function
AU - Wang, Q.
AU - Zhang, X. D.
AU - Liu, X.
AU - Yang, Y. Q.
N1 - Publisher Copyright:
© 2015, Urban & Vogel.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background: Renal impairment and atrial fibrillation (AF) often coexist. Catheter ablation is an effective way to reduce the burden of AF and improve symptoms; however, little is known about the relationship between renal function and AF and its role in the progression of AF for patients undergoing repeat catheter ablation. Methods: In all, 171 patients with long-standing persistent AF ablation were enrolled in the study. The patients were divided into two groups according to their delta estimated glomerular filtration rate (eGFR) values, which was defined as the eGFR before the repeat procedure minus the eGFR before the initial procedure. Patients with decreasing eGFR (delta eGFR < 0) were categorized as group I, while individuals with no change or increasing eGFR (delta eGFR≥ 0) were categorized as group II. eGFR was estimated at baseline and at the 12-month and 24-month follow-up visits. Results: After a mean follow-up of 31.4 ± 13.2 months, group I had a significantly higher arrhythmia recurrence rate than group II (71.2 vs. 49.2 %, p < 0.001). On multivariable analyses, eGFR changes after the repeat procedure were associated with arrhythmia recurrence, hypertrophic cardiomyopathy, and CHA2DS2-VASc score. Patients with arrhythmia recurrence and those with a CHA2DS2-VASc score of ≥ 3 were more likely to show an eGFR decline at follow-up. Conclusion: Patients with long-standing persistent AF, with a failed initial ablation procedure and undergoing a repeat ablation procedure, appear to have a higher risk of arrhythmia recurrence. During the follow-up period, patients without arrhythmia recurrence and those with a CHA2DS2-VASc score of < 3 show improved renal function.
AB - Background: Renal impairment and atrial fibrillation (AF) often coexist. Catheter ablation is an effective way to reduce the burden of AF and improve symptoms; however, little is known about the relationship between renal function and AF and its role in the progression of AF for patients undergoing repeat catheter ablation. Methods: In all, 171 patients with long-standing persistent AF ablation were enrolled in the study. The patients were divided into two groups according to their delta estimated glomerular filtration rate (eGFR) values, which was defined as the eGFR before the repeat procedure minus the eGFR before the initial procedure. Patients with decreasing eGFR (delta eGFR < 0) were categorized as group I, while individuals with no change or increasing eGFR (delta eGFR≥ 0) were categorized as group II. eGFR was estimated at baseline and at the 12-month and 24-month follow-up visits. Results: After a mean follow-up of 31.4 ± 13.2 months, group I had a significantly higher arrhythmia recurrence rate than group II (71.2 vs. 49.2 %, p < 0.001). On multivariable analyses, eGFR changes after the repeat procedure were associated with arrhythmia recurrence, hypertrophic cardiomyopathy, and CHA2DS2-VASc score. Patients with arrhythmia recurrence and those with a CHA2DS2-VASc score of ≥ 3 were more likely to show an eGFR decline at follow-up. Conclusion: Patients with long-standing persistent AF, with a failed initial ablation procedure and undergoing a repeat ablation procedure, appear to have a higher risk of arrhythmia recurrence. During the follow-up period, patients without arrhythmia recurrence and those with a CHA2DS2-VASc score of < 3 show improved renal function.
KW - Atrial fibrillation
KW - CHADS-VASc score
KW - Estimated glomerular filtration rate
KW - Renal function
KW - Repeat catheter ablation
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U2 - 10.1007/s00059-015-4371-7
DO - 10.1007/s00059-015-4371-7
M3 - Article
C2 - 26809454
AN - SCOPUS:84955269106
SN - 0340-9937
VL - 41
SP - 331
EP - 341
JO - Herz
JF - Herz
IS - 4
ER -