Renal dysfunction and atrial fibrillation recurrence following cardioversion

Area of Science:

• Cardiology
• Nephrology

Background:

• Atrial fibrillation (AF) recurrence post-cardioversion is a clinical challenge.
• The predictive role of renal impairment in AF recurrence after cardioversion remains understudied.

Purpose of the Study:

• To investigate the association between renal function, assessed by estimated glomerular filtration rate (eGFR), and the long-term risk of AF recurrence following successful cardioversion.

Main Methods:

• 159 patients with persistent AF undergoing cardioversion were prospectively followed for 1 year.
• Renal function was evaluated using baseline and follow-up eGFR.
• AF recurrence and eGFR changes were monitored.

Main Results:

• 64% of patients experienced AF recurrence within 1 year.
• Reduced baseline eGFR was independently associated with higher AF recurrence rates (e.g., HR 6.82 for eGFR <30 mL/min).
• Patients maintaining sinus rhythm showed improved eGFR, while those with recurrence experienced eGFR decline.

Conclusions:

• Impaired renal function is a significant predictor of increased AF recurrence risk after cardioversion.
• Preserving sinus rhythm may lead to renal function improvement, particularly in patients with mild to moderate renal insufficiency.