Abstract 14729: Changes in Renal Function After Radiofrequency Catheter Ablation of Atrial Fibrillation Are Associated With CHA2DSs-Vasc Score: The Leipzig Heart Center AF Ablation Registry
Background: Radiofrequency catheter ablation (RFA) of atrial fibrillation (AF) is effective for rhythm control. However, the long-term effects of RFA on renal function as measured by estimated glomerular filtration rate, eGFR have not been studied in large contemporary AF cohorts.
Methods: 2,069 patients with at least 12 months follow-up were included in The Leipzig Heart Center AF Ablation Registry. The eGFR was assessed at baseline and at follow-up in 1,455 patients. The eGFR was estimated using the Cockcroft-Gault equation. Significant changes in eGFR were defined as decline or improvement >10 ml/min/1.73m2 from baseline levels.
Results: The study population was 66% male, with mean age 61 ± 10 years, 59% paroxysmal AF and median follow-up of 23 [IQR 12 - 35] months. eGFR at baseline and at follow up correlated negatively with both CHADS2 (p<0.001, Beta -0.134 and p<0.001, Beta -0.162, respectively) and CHA2DS2-VASc scores (p<0.001, Beta -0.403 and p<0.001, Beta -0.426, respectively). On uni- and multivariate analysis, both CHADS2 (OR 1.3, 95% CI 1.02 - 1.6, p=0.03) and CHA2DS2-VASc (OR 2.1, 95% CI 1.8 - 2.4, p<0.001) scores were associated with eGFR <60 ml/min/1.73m2 at follow up.
During follow up, there was an eGFR decline in 19% (n=276, relative change -17.5% [-25.3 --13.11]) and an eGFR increase in 28% (n=404) of patients (relative change 18.3% [14.3 - 25.6]). On uni- and multivariable analysis, a higher CHA2DS2-VASc (OR 1.1, 95% CI 1.04-1.2, p=0.023) and a lower ejection fraction (OR 0.985, 95% CI 0.97-0.99, p=0.004) were associated with eGFR reduction, whereas lower CHA2DS2-VASc (OR 0.854, 95% CI 0.77 - 0.95, p=0.002) and higher LVEDd (OR 1.02, 95% CI 1.002 - 1.043, p=0.035) were associated with eGFR improvement after catheter ablation. There was no association with rhythm outcome.
Conclusions: eGFR worsening (19%) and improvement (28%) are prevalent after AF catheter ablation and are associated with the CHA2DS2-VASc score but not rhythm outcome.
- © 2013 by American Heart Association, Inc.