Improvement in Estimated Glomerular Filtration Rate in Patients with Chronic Kidney Disease Undergoing Catheter Ablation for Atrial Fibrillation. (26th September 2014)

• Record Type: Journal Article
• Authors: NAVARAVONG, LEENHAPONG; BARAKAT, MICHEL; BURGON, NATHAN; MAHNKOPF, CHRISTIAN; KOOPMANN, MATTHIAS; RANJAN, RAVI; KHOLMOVSKI, EUGENE; MARROUCHE, NASSIR; AKOUM, NAZEM
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 26:Number 1(2015:Jan.)
• Page Start: 21
• Page End: 27
• Publication Date: 2014-09-26
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12530
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>AF Ablation and eGFR</title> <sec id="jce12530-sec-0010" sec-type="section"> <title>Introduction</title> <p>Chronic kidney disease (CKD) and atrial fibrillation (AF) often coexist. We studied the association of CKD with atrial fibrosis and the effect of AF ablation on kidney function.</p> </sec> <sec id="jce12530-sec-0020" sec-type="section"> <title>Methods</title> <p>AF patients who had a pre‐ and postablation serum creatinine and who completed a late gadolinium enhancement cardiac magnetic resonance imaging (MRI; LGE‐MRI) prior to ablation were included. Estimated glomerular filtration rate (eGFR) was calculated and CKD was staged using the National Kidney Foundation guidelines. Patients with eGFR <30 mL/min/1.73 m<sup>2</sup> were excluded. LGE‐MRI was used to quantify atrial fibrosis. Patients were followed for recurrence and change in eGFR.</p> </sec> <sec id="jce12530-sec-0030" sec-type="section"> <title>Results</title> <p>A total of 392 patients were included in the study. A total of 118 (30.2%) had CKD stage 1, 198 (50.4%) CKD stage 2, 56 (14.3%) CKD stage 3A, and 20 (5.1%) CKD stage 3B. Patients with advanced CKD were more likely to be male and to have cardiovascular disease. Atrial fibrosis was not significant different between included CKD stages: 15.8 ± 8.8%, 16.6 ± 12.1%, 17.1 ± 10.4%, and 16.5 ± 8.4% for CKD stage 1, 2, 3A, and 3B, respectively (P = 0.476). At a median of 115 days following ablation, eGFR increased significantly in CKD stage 2 (74 ± 9 to 80 ± 23; P = 0.04), 3A (53 ± 5 to 69 ± 24; P < 0.001), and 3B (40 ± 4 to 71 ± 28; P < 0.01) and decreased in CKD stage 1 (109 ± 18 to 82 ± 28; P < 0.001). Arrhythmia recurrence was associated with atrial fibrosis (hazard ratio [HR] = 1.04, P < 0.01) and persistent AF (HR = 1.5; P = 0.04) but not with CKD stage (HR = 0.98; P = 0.89).</p> </sec> <sec id="jce12530-sec-0040" sec-type="section"> <title>Conclusions</title> <p>Restoring sinus rhythm with ablation leads to significant improvement of renal function in patients with chronic kidney disease.</p> </sec> </abstract>