Decreased eGFR predicts long-term recurrence after catheter ablation of atrial fibrillation

Abstract

Background: Catheter ablation is an established therapy for atrial fibrillation (AF), but recurrence after ablation is still a great challenge. A higher prevalence of AF has been reported among patients with chronic renal disease. However, little is known about the effect of renal function on the efficiency of AF ablation. This study aimed to evaluate the effect of renal function on the prognosis of catheter ablation for AF. Methods: A total of 306 consecutive drug-refractory symptomatic patients with AF who underwent first-time catheter ablation were enrolled in the present study. The individuals underwent circumferential pulmonary vein isolation for paroxysmal AF and stepwise ablation for persistent AF. Results: Following up 27.2 ± 19.5 months after a single procedure, 202 patients (66.01%) were free of atrial tachyarrhythmia (non-recurrence group), and the other 104 patients experienced recurrence (recurrence group). The recurrence group had a larger left atrial diameter (LAD) and left atrial volume (LAV), a higher LAV index (LAVI) (p < 0.01, respectively), and a lower estimated glomerular filtration rate (eGFR) (53.5 ± 14.4 vs. 65.5 ± 13.3 ml/min/1.732, p < 0.001) and creatinine clearance rate (CCr) (85.2 ± 26.1 vs. 101.5 ± 29.4 ml/min, p < 0.05). Multivariate logistic analysis indicated eGFR and LAVI as independent predictors of long-term recurrence after single catheter ablation. Conclusion: Decreased eGFR and elevated LAVI may facilitate the long-term recurrence of atrial tachyarrhythmia after catheter ablation for AF.