Abstract 14321: Severity of Chronic Kidney Disease Correlates With the Prevalence of Left Atrial Low-voltage Areas
Introduction: The presence of left atrial low-voltage areas (LVA) has been shown to be strongly associated with atrial fibrillation recurrence after pulmonary vein isolation. A preliminary study has shown concomitant chronic kidney disease (CKD) increased the rate of recurrence of atrial fibrillation. However the association between CKD and LVA presence are not fully determined.
Hypothesis: The severity of CKD correlates with the prevalence of left atrial LVA.
Methods: This study included 183 patients who underwent the initial ablation for atrial fibrillation (age, 67 ± 9 years old; male, 134 (73%) patients; persistent atrial fibrillation, 82 (45%) patients). LVA was defined as sites of the left atrial electrogram amplitude<0.5mV. Serum creatinine and cystatin C levels before ablation were measured, and estimated glomerular filtration rate (eGFR) was calculated.
Results: Of 183 patients, 76 (42%) patients had LVA. Patients with LVA demonstrated lower eGFR calculated by cystatin C (73.8±21.9 versus 86.2±23.9 ml/min/1.73m2, P <0.001) and lower eGFR calculated by creatinine (60.3±14.1 versus 66.3±16.0 ml/min/1.73m2, P =0.01). Receiver operating characteristic curve analysis revealed that eGFR calculated by cystatin C was a better predictor of LVA presence than that by creatine (area under the curve, 0.669 versus 0.617). LVA existed more frequently in patients with more severe categories of CKD (Figure). The optimal cut-off value of eGFR calculated by cystatin C was 71.5ml/min/1.73m2 corresponded to 79.4% sensitivity, 50.0% specificity and 67.2% predictive accuracy. In the multivariate analysis, independent predictors of LVA presence were eGFR<71.5ml/min/1.73m2 (odds ratio (OR) 2.8 [95% confidence interval (CI) 1.3-6.1], P =0.012) and high age (OR 1.05 [95% CI 1.01-1.10], P =0.028).
Conclusions: The severity of CKD correlates with left atrial LVA prevalence in patients with atrial fibrillation undergoing catheter ablation.
Author Disclosures: Y. Matsuda: None. M. Masuda: None. M. Fujita: None. O. Iida: None. S. Okamoto: None. T. Ishihara: None. K. Nanto: None. T. Kanda: None. A. Sunaga: None. T. Tsujimura: None. S. Okuno: None. K. Yanaka: None. T. Ohashi: None. H. Kawai: None. A. Tsuji: None. Y. Hata: None. M. Uematsu: None.
- © 2016 by American Heart Association, Inc.