Association Between Renal Function and Left Atrial Low-Voltage Area Burden in Paroxysmal Atrial Fibrillation

Area of Science:

• Cardiology
• Nephrology
• Electrophysiology

Background:

• Circumferential pulmonary vein isolation (CPVI) with left atrial low-voltage areas (LVA) modification treats paroxysmal atrial fibrillation (PAF).
• Predicting LVA burden pre-ablation is challenging.
• Chronic kidney disease (CKD) is associated with increased left atrial LVA prevalence.

Purpose of the Study:

• To investigate the relationship between renal function and LVA burden in elderly patients with PAF.
• To determine if renal function can predict LVA burden in this patient group.

Main Methods:

• Retrospective analysis of 435 elderly patients with PAF undergoing ablation.
• Patients categorized into four groups based on LVA burden (≤5%, 5%-10%, 10%-15%, >15%).
• Correlation between estimated glomerular filtration rate (eGFR) and LVA burden analyzed.

Main Results:

• A progressive decline in eGFR was observed with increasing LVA burden.
• Significant eGFR difference between lowest and highest LVA burden groups (p=0.003).
• eGFR predicted LVA burden >10% with optimal cut-off at 75.7 mL/min/1.73 m², showing 54.2% sensitivity and 80.4% specificity.

Conclusions:

• Reduced eGFR is associated with higher LVA burden in elderly PAF patients.
• Renal function, specifically eGFR, may serve as a predictor for significant LVA burden.