Skip to main content
Erschienen in: Herz 4/2016

25.01.2016 | Original article

Renal function after repeat catheter ablation for long-standing persistent atrial fibrillation

Low CHA2DS2-VASc score and sinus rhythm predict improved renal function

verfasst von: Q. Wang, MD, X.-D. Zhang, MD, X. Liu, MD, Y.-Q. Yang, MD

Erschienen in: Herz | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Go AS, Chertow GM, Fan D et al (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305CrossRefPubMed Go AS, Chertow GM, Fan D et al (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305CrossRefPubMed
2.
Zurück zum Zitat Goudis CA, Kallergis EM, Vardas PE (2012) Extracellular matrix alterations in the atria: insights into the mechanisms and perpetuation of atrial fibrillation. Europace 14:623–630CrossRefPubMed Goudis CA, Kallergis EM, Vardas PE (2012) Extracellular matrix alterations in the atria: insights into the mechanisms and perpetuation of atrial fibrillation. Europace 14:623–630CrossRefPubMed
3.
Zurück zum Zitat Soliman EZ, Prineas RJ, Go AS et al (2010) Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J 159:1102–1107CrossRefPubMedPubMedCentral Soliman EZ, Prineas RJ, Go AS et al (2010) Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J 159:1102–1107CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Takahashi Y, Takahashi A, Kuwahara T et al (2011) Renal function after catheter ablation of atrial fibrillation. Circulation 124:2380–2387CrossRefPubMed Takahashi Y, Takahashi A, Kuwahara T et al (2011) Renal function after catheter ablation of atrial fibrillation. Circulation 124:2380–2387CrossRefPubMed
5.
Zurück zum Zitat Chao TF, Lin YJ, Chang SL et al (2011) Associations between renal function, atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation. Circ J 75:2326–2332CrossRefPubMed Chao TF, Lin YJ, Chang SL et al (2011) Associations between renal function, atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation. Circ J 75:2326–2332CrossRefPubMed
6.
Zurück zum Zitat Berkowitsch A, Kuniss M, Greiss H et al (2012) Impact of impaired renal function and metabolic syndrome on the recurrence of atrial fibrillation after catheter ablation: a long term follow-up. Pacing Clin Electrophysiol 35:532–543CrossRefPubMed Berkowitsch A, Kuniss M, Greiss H et al (2012) Impact of impaired renal function and metabolic syndrome on the recurrence of atrial fibrillation after catheter ablation: a long term follow-up. Pacing Clin Electrophysiol 35:532–543CrossRefPubMed
7.
Zurück zum Zitat Liu X, Tan HW, Wang XH et al (2010) Efficacy of catheter ablation and surgical CryoMaze procedure in patients with long-lasting persistent atrial fibrillation and rheumatic heart disease: a randomized trial. Eur Heart J 31:2633–2641CrossRefPubMed Liu X, Tan HW, Wang XH et al (2010) Efficacy of catheter ablation and surgical CryoMaze procedure in patients with long-lasting persistent atrial fibrillation and rheumatic heart disease: a randomized trial. Eur Heart J 31:2633–2641CrossRefPubMed
8.
Zurück zum Zitat Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470CrossRefPubMed Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470CrossRefPubMed
9.
Zurück zum Zitat National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266 National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266
11.
Zurück zum Zitat Iguchi Y, Kimura K, Kobayashi K, Aoki J et al (2008) Relation of atrial fibrillation to glomerular filtration rate. Am J Cardiol 102:1056–1059CrossRefPubMed Iguchi Y, Kimura K, Kobayashi K, Aoki J et al (2008) Relation of atrial fibrillation to glomerular filtration rate. Am J Cardiol 102:1056–1059CrossRefPubMed
12.
Zurück zum Zitat Horio T, Iwashima Y, Kamide K et al (2010) Chronic kidney disease as an independent risk factor for new-onset atrial fibrillation in hypertensive patients. J Hypertens 28:1738–1744CrossRefPubMed Horio T, Iwashima Y, Kamide K et al (2010) Chronic kidney disease as an independent risk factor for new-onset atrial fibrillation in hypertensive patients. J Hypertens 28:1738–1744CrossRefPubMed
13.
Zurück zum Zitat Schmidt M, Rieber J, Daccarett M et al (2010). Relation of recurrence of atrial fibrillation after successful cardioversion to renal function. Am J Cardiol 105:368–372CrossRefPubMed Schmidt M, Rieber J, Daccarett M et al (2010). Relation of recurrence of atrial fibrillation after successful cardioversion to renal function. Am J Cardiol 105:368–372CrossRefPubMed
14.
Zurück zum Zitat Tokuda M, Yamane T, Matsuo S et al (2011). Relationship between renal function and the risk of recurrent atrial fibrillation following catheter ablation. Heart 97:137–142CrossRefPubMed Tokuda M, Yamane T, Matsuo S et al (2011). Relationship between renal function and the risk of recurrent atrial fibrillation following catheter ablation. Heart 97:137–142CrossRefPubMed
16.
Zurück zum Zitat Goette A, Staack T, Röcken C et al (2000) Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol 35:1669–1677CrossRefPubMed Goette A, Staack T, Röcken C et al (2000) Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol 35:1669–1677CrossRefPubMed
17.
Zurück zum Zitat Li J, Solus J, Chen Q et al (2010) Role of inflammation and oxidative stress in atrial fibrillation. Heart Rhythm 7:438–444CrossRefPubMed Li J, Solus J, Chen Q et al (2010) Role of inflammation and oxidative stress in atrial fibrillation. Heart Rhythm 7:438–444CrossRefPubMed
18.
Zurück zum Zitat Sasaki N, Okumura Y, Watanabe I et al (2014) Increased levels of inflammatory and extracellular matrix turnover biomarkers persist despite reverse atrial structural remodeling during the first year after atrial fibrillation ablation. J Interv Card Electrophysiol 39:241–249CrossRefPubMed Sasaki N, Okumura Y, Watanabe I et al (2014) Increased levels of inflammatory and extracellular matrix turnover biomarkers persist despite reverse atrial structural remodeling during the first year after atrial fibrillation ablation. J Interv Card Electrophysiol 39:241–249CrossRefPubMed
19.
Zurück zum Zitat Hussein AA, Saliba WI, Martin DO et al (2011) Natural history and long-term outcomes of ablated atrial fibrillation. Circ Arrhythm Electrophysiol 4:271–278CrossRefPubMed Hussein AA, Saliba WI, Martin DO et al (2011) Natural history and long-term outcomes of ablated atrial fibrillation. Circ Arrhythm Electrophysiol 4:271–278CrossRefPubMed
20.
Zurück zum Zitat Maekawa Y, Jinzaki M, Tsuruta H et al (2015) Improved renal function in a patient with hypertrophic obstructive cardiomyopathy after multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation. Int J Cardiol 181:349–350CrossRefPubMed Maekawa Y, Jinzaki M, Tsuruta H et al (2015) Improved renal function in a patient with hypertrophic obstructive cardiomyopathy after multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation. Int J Cardiol 181:349–350CrossRefPubMed
21.
Zurück zum Zitat Kornej J, Hindricks G, Banerjee A et al (2015) Changes in renal function after catheter ablation of atrial fibrillation are associated with CHADS2 and CHA2DS 2-VASc scores and arrhythmia recurrences. Heart 101:126–131CrossRefPubMed Kornej J, Hindricks G, Banerjee A et al (2015) Changes in renal function after catheter ablation of atrial fibrillation are associated with CHADS2 and CHA2DS 2-VASc scores and arrhythmia recurrences. Heart 101:126–131CrossRefPubMed
22.
Zurück zum Zitat Lin KJ, Cho SI, Tiwari N et al (2014) Impact of metabolic syndrome on the risk of atrial fibrillation recurrence after catheter ablation: systematic review and meta-analysis. J Interv Card Electrophysiol 39:211–223CrossRefPubMed Lin KJ, Cho SI, Tiwari N et al (2014) Impact of metabolic syndrome on the risk of atrial fibrillation recurrence after catheter ablation: systematic review and meta-analysis. J Interv Card Electrophysiol 39:211–223CrossRefPubMed
23.
Metadaten
Titel
Renal function after repeat catheter ablation for long-standing persistent atrial fibrillation
Low CHA2DS2-VASc score and sinus rhythm predict improved renal function
verfasst von
Q. Wang, MD
X.-D. Zhang, MD
X. Liu, MD
Y.-Q. Yang, MD
Publikationsdatum
25.01.2016
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 4/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-015-4371-7

Weitere Artikel der Ausgabe 4/2016

Herz 4/2016 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.