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Renal function and outcomes in atrial fibrillation patients after catheter ablation
Tetsuma Kawaji1,2, Satoshi Shizuta2, Takanori Aizawa2
1Department of Cardiology, Ryorei Memorial Kyoto Hospital, Kyoto, Japan.
Plos One
|November 9, 2020
Summary
Recurrent atrial fibrillation (AF) after ablation worsens kidney function and predicts poor outcomes. Managing AF recurrence is crucial for preserving renal health and improving survival in these patients.
Area of Science:
- Cardiology
- Nephrology
- Clinical Outcomes Research
Background:
- Atrial fibrillation (AF) and renal dysfunction frequently coexist.
- Limited data exist on the relationship between renal function and outcomes post-AF ablation.
Purpose of the Study:
- To assess long-term renal function changes after AF catheter ablation.
- To determine the impact of renal function on clinical outcomes in AF patients undergoing ablation.
Main Methods:
- 791 non-dialysis patients undergoing AF catheter ablation were enrolled.
- Worsening renal function (WRF) defined as >30% decline in estimated glomerular filtration rate (eGFR) was evaluated.
- Long-term follow-up (mean 5.1 years) assessed arrhythmia recurrence and clinical events.
Main Results:
- Cumulative 5-year incidence of WRF was 13.2%, significantly higher in patients with recurrent AF (21.6%) vs. without (8.7%).
- Recurrent AF independently predicted WRF (aHR 1.89), along with heart failure, diabetes, and baseline eGFR <60.
- WRF was associated with significantly higher 5-year risks of all-cause death, cardiovascular death, heart failure hospitalization, stroke, and bleeding.
Conclusions:
- Arrhythmia recurrence post-AF ablation is linked to worsening renal function.
- Worsening renal function is a strong predictor of adverse clinical outcomes, including mortality and hospitalization.
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