Changes in Renal Function in Patients with Recurrence of Atrial
Arrhythmia after an Initial Catheter Ablation
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 AF patients with mild renal
dysfunction after an index failed catheter ablation and the influencing
factors. Methods: We retrospectively recruited non-valvular 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 (P < 0.01). The multivariable Cox
regression analysis showed that a lower △CHA2DS2-VASc score (HR: 0.416,
P = 0.003) and paroxysmal recurrent atrial arrhythmia (HR: 2.965, 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.