Chronic Kidney Disease with Mild and Mild to Moderate Reduction in Renal Function and Long-Term Recurrences of Atrial Fibrillation after Pulmonary Vein Cryoballoon Ablation

Journal of Cardiovascular Development and Disease

on behalf of the 1STOP ClinicalService Investigators¹  Maurizio Landolina²  Giovanni Rovaris³  Antonio Curnis⁴  Giuseppe Boriani⁵  Marco Vitolo⁵  Claudio Tondo⁶  Saverio Iacopino⁷  Giulio Molon⁸  Giovanni Battista Perego⁹  Paolo Pieragnoli^1,10  Massimiliano Manfrin^1,11  Giuseppe Arena^1,12  Antonio Dello Russo^1,13  Roberto Verlato^1,14 

[1] ;ASST Ospedale Maggiore, 26013 Crema, Italy;ASST San Gerardo di Monza, 20900 Monza, Italy;ASST degli Spedali Civili, 25123 Brescia, Italy;Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy;Department of Clinical Electrophysiology & Cardiac Pacing, Heart Rhythm Center, Monzino Cardiac Center IRCCS, 20122 Milan, Italy;Electrophysiology Unit, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy;IRCCS Sacro Cuore don Calabria, 37024 Negrar, Italy;Istituto Auxologico Italiano IRCCS, Ospedale San Luca, 55100 Milano, Italy;Ospedale Careggi, University of Florence, 50121 Firenze, Italy;Ospedale San Maurizio, 39100 Bolzano, Italy;Ospedale delle Apuane, 54100 Massa, Italy;Ospedali Riuniti Torrette di Ancona, 60126 Torrette, Italy;ULSS 6 Euganea, Ospedale di Camposampiero-Cittadella, 35013 Cittadella, Italy;

关键词: atrial fibrillation;    cryoablation;    chronic kidney disease;    catheter ablation;    rhythm control;   

DOI  :  10.3390/jcdd9050126

来源: DOAJ

【 摘 要 】

The aim of this research was to evaluate if patients with chronic kidney disease (CKD) and mild or mild to moderate depression of renal function have an increased risk of atrial fibrillation (AF) recurrences after cryoballoon (CB) ablation. We performed a retrospective analysis of AF patients undergoing pulmonary vein isolation (PVI) by CB. The cohort was divided according to the KDIGO CKD-EPI classification into a (1) normal, (2) mildly decreased, or (3) mild to moderate reduction in estimated glomerular filtration rate (eGFR). Freedom from AF recurrences was the primary endpoint. A total of 1971 patients were included (60 ± 10 years, 29.0% females, 73.6% paroxysmal AF) in the study. Acute success and complication rates were 99.2% and 3.7%, respectively, with no significant differences among the three groups. After a follow-up of 24 months, AF recurrences were higher in the mildly and mild to moderate CKD groups compared to the normal kidney function group (23.4% vs. 28.3% vs. 33.5%, p < 0.05). Mild to moderate CKD was an independent predictor of AF recurrences after the blanking period (hazard ratio:1.38, 95% CI 1.02–1.86, p = 0.037). In conclusion, a multicenter analysis of AF patients treated with cryoablation revealed mild to moderate reductions in renal functions were associated with a higher risk of AF recurrences. Conversely, the procedural success and complication rates were similar in patients with normal, mildly reduced, or mild to moderate reduction in eGFR.

【 授权许可】

Unknown