PMID- 34674646
OWN - NLM
STAT- MEDLINE
DCOM- 20220128
LR  - 20231225
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Oct 21
TI  - Decreased estimated glomerular filtration rate predicts long-term recurrence 
      after catheter ablation of atrial fibrillation in mild to moderate renal 
      insufficiency.
PG  - 508
LID - 10.1186/s12872-021-02320-y [doi]
LID - 508
AB  - BACKGROUND: Catheter ablation is an established therapy for atrial fibrillation 
      (AF), but recurrence after ablation remains a great challenge. Additionally, 
      little is known about the effect of renal function on the efficiency of AF 
      ablation. This study aimed to evaluate the predictors of the prognosis of 
      catheter ablation for AF, especially the effect of renal function. METHODS: A 
      total of 306 drug-refractory symptomatic patients with AF who underwent 
      first-time catheter ablation were enrolled in the present study. Individuals 
      underwent circumferential pulmonary vein isolation for paroxysmal AF and stepwise 
      ablation for persistent AF. RESULTS: The follow-up time was 27.2 +/- 19.5 months, 
      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) (both, p < 0.01), and a lower estimated 
      glomerular filtration rate (eGFR) (53.5 +/- 14.4 vs. 65.5 +/- 13.3 ml/min/1.73(2), 
      p < 0.001) and creatinine clearance rate (CCr) (85.2 +/- 26.1 vs. 
      101.5 +/- 29.4 ml/min, p < 0.05). Multivariate logistic regression indicated both 
      eGFR (p = 0.002) and LAVI (p < 0.001) as independent associated factors for 
      long-term recurrence after single catheter ablation; multivariate Cox 
      proportional hazard regression with backward feature selection identified both 
      eGFR (HR: 0.93, 95% CI: 0.91-0.95, p < 0.001) and LAVI (HR: 1.32, 95% CI: 
      1.25-1.40, p < 0.001) as independent prognostic factors for recurrence when 
      adjusting other clinical variables. CONCLUSIONS: Decreased eGFR and elevated LAVI 
      may facilitate the long-term recurrence of atrial tachyarrhythmia after catheter 
      ablation for AF.
CI  - (c) 2021. The Author(s).
FAU - Zheng, Jing
AU  - Zheng J
AD  - Department of Cardiology, The Quzhou Affiliated Hospital of Wenzhou Medical 
      University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
FAU - Zu, Deling
AU  - Zu D
AD  - Department of Cardiology, The Quzhou Affiliated Hospital of Wenzhou Medical 
      University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
FAU - Cheng, Keyun
AU  - Cheng K
AD  - Department of Cardiology, The Quzhou Affiliated Hospital of Wenzhou Medical 
      University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
FAU - Xia, Yunlong
AU  - Xia Y
AD  - Department of Cardiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian, 116000, Liaoning, China.
FAU - Dong, Yingxue
AU  - Dong Y
AD  - Department of Cardiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian, 116000, Liaoning, China. dlsusan@126.com.
FAU - Gao, Zhenyan
AU  - Gao Z
AD  - Department of Cardiology, The Quzhou Affiliated Hospital of Wenzhou Medical 
      University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China. 
      gaozhenyan80@163.com.
LA  - eng
PT  - Journal Article
DEP - 20211021
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Adult
MH  - Aged
MH  - Atrial Fibrillation/complications/*surgery
MH  - *Catheter Ablation
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - *Glomerular Filtration Rate
MH  - Heart Atria/*anatomy & histology
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - ROC Curve
MH  - Recurrence
MH  - Renal Insufficiency/complications/*physiopathology
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC8529753
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Catheter ablation
OT  - Estimated glomerular filtration rate
OT  - Mild to moderate renal insufficiency
OT  - Recurrence
COIS- The authors declare that they have no competing interests.
EDAT- 2021/10/23 06:00
MHDA- 2022/01/29 06:00
PMCR- 2021/10/21
CRDT- 2021/10/22 05:30
PHST- 2021/05/25 00:00 [received]
PHST- 2021/10/06 00:00 [accepted]
PHST- 2021/10/22 05:30 [entrez]
PHST- 2021/10/23 06:00 [pubmed]
PHST- 2022/01/29 06:00 [medline]
PHST- 2021/10/21 00:00 [pmc-release]
AID - 10.1186/s12872-021-02320-y [pii]
AID - 2320 [pii]
AID - 10.1186/s12872-021-02320-y [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2021 Oct 21;21(1):508. doi: 10.1186/s12872-021-02320-y.