Korean Circ J.  2015 Nov;45(6):473-478. 10.4070/kcj.2015.45.6.473.

Impact of Impaired Renal Function on the Incidence of Atrial Fibrillation following Radiofrequency Ablation of Cavotricuspid Isthmus-Dependent Atrial Flutter

• Kwon CH
• Kim J
• Kim MS
• Roh JH
• Choi JH
• Jo U
• Lee WS
• Kim YR
• Nam GB
• Choi KJ
• Kim YH

• KMID: 2223785
• DOI: http://doi.org/10.4070/kcj.2015.45.6.473

Abstract

BACKGROUND AND OBJECTIVES
Atrial fibrillation (AF) occurs frequently after successful radiofrequency ablation (RFA) of cavotricuspid isthmus-dependent atrial flutter (CTI-AFL). Renal impairment has been implicated in the development of AF. The purpose of this study is to clarify the impact of impaired renal function on the incidence of AF after RFA of CTI-AFL.
SUBJECTS AND METHODS
Between January 2001 and December 2013, 240 non-dialysis patients with no prior history of AF {mean age 55.9+/-15.2 years old; male, 192 (80.0%)} who had undergone successful CTI-AFL ablation were included in the present study. The baseline estimated glomerular filtration rate was calculated, and patients were divided into those with impaired renal function (<60 mL/min/1.73 m2) and those with preserved renal function (> or = 60 mL/min/1.73 m2). The incidence of AF was retrospectively analyzed.
RESULTS
69 (28.8%) patients experienced new onset AF during a median follow-up duration of 26 months (inter-quartile, 7-53). The incidence of AF was significantly higher in patients with impaired renal function than in those with preserved renal function {13/25 (52.0%) versus 56/215 (26.0%), log rank p=0.019}. Age, CHADS2 score, impaired renal function, and left atrial diameter were significantly associated with the incidence of AF in univariate Cox regression analysis. Multivariate analysis showed that age was the only significant predictor of AF incidence (hazard ratio, 1.024; 95% confidence interval, 1.004-1.044, p=0.020).
CONCLUSION
Patients with impaired renal function may require careful attention for the incidence of new onset AF following successful RFA of CTI-AFL.

Keyword

Atrial fibrillation; Atrial flutter; Renal insufficiency; Catheter ablation

MeSH Terms

Atrial Fibrillation*
Atrial Flutter*
Catheter Ablation*
Follow-Up Studies
Glomerular Filtration Rate
Humans
Incidence*
Male
Multivariate Analysis
Renal Insufficiency
Retrospective Studies

Figure

• 

  Fig. 1 Kaplan-Meier curves showing the probability of survival free atrial fibrillation during post-ablation follow-up between the patients with or without impaired renal function. (< 60 mL/min/1.73 m2).

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