Effect of Atrial Fibrillation Recurrence on Renal Function after Prior Ablation

Researchers, led by Youmei Shen, found that even patients with non-valvular atrial fibrillation (NVAF) who experienced recurrence after an initial catheter ablation had improved renal function, which was associated with a lower △CHA2DS2-VASc score and paroxysmal recurrent arrhythmia. Their findings were published in the International Journal of Clinical Practice.

The researchers retrospectively evaluated 132 patients with NVAF with mildly impaired renal function who were admitted for catheter ablation and later readmitted for atrial fibrillation recurrence. The effect of recurrence on estimated glomerular filtration rate (eGFR) and △CHA2DS2-VASc score was calculated as the difference from baseline to readmission. The primary outcome was improvement in renal function.

According to the report, patients’ mean eGFR at readmission was significantly higher compared to baseline eGFR prior to the initial ablation (81.5 ± 1.1 vs. 78.0 ± 0.7 ml/min/1.73 m²; P <.001).

Additionally, the authors’ multivariable Cox regression analysis determined that lower △CHA2DS2-VASc score (hazard ratio [HR]: 0.42; P=.003) and paroxysmal recurrent atrial arrhythmia (HR: 2.97; P=.001) were both associated with improved renal function.

Based on their comparisons of eGFR before ablation and eGFR during readmission, the authors concluded that “renal function could still be improved after [radiofrequency catheter ablation] in NVAF patients with a mildly decreased eGFR, even if they had recurrent atrial arrhythmia.”