In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2020-11-9), p. e0241449-
Abstract:
Atrial fibrillation (AF) and renal failure coexist and interact. However, scarce data about association between renal function and clinical outcomes in patients undergoing catheter ablation for AF are available. We sought to evaluate long-term renal function and clinical outcomes after AF ablation. Methods We enrolled 791 non-dialysis patients undergoing catheter ablation for AF, and evaluated the incidence of worsening renal function (WRF) after the procedure, defined as 〉 30% decline in estimate glomerular filtration rate. Results Mean follow-up duration was 5.1±2.5 years. Five hundreds and twenty-six patients (66.5%) were free from recurrent atrial arrhythmias without any antiarrhythmic drugs at the time of final follow-up. Cumulative incidence of WRF was 13.2% at 5-year after procedure, which was significantly higher in patients with recurrent AF compared to those without (21.6% versus 8.7%, P 〈 0.001). In the multivariable analysis, recurrent AF was an independent risk factor for WRF (adjusted hazard ratio [HR] 1.89, 95% confidence interval 1.27–2.81, P = 0.002), along with congestive heart failure, diabetes, and eGFR 〈 60 ml/min/1.73m 2 at baseline. Patients with WRF had significantly higher 5-year incidences of all-cause death, cardiovascular death, heart failure hospitalization, ischemic stroke, and major bleeding compared to those without WRF. After adjustment of baseline differences in the multivariate Cox model, the excessive risks of WRF for all-cause death and heart failure hospitalization remained significant (adjusted HR 3.46, P = 0.002; adjusted HR 3.67, P 〈 0.001). Conclusions In AF patients undergoing catheter ablation for AF, arrhythmia recurrence was associated with WRF during follow-up, which was a strong predictor of adverse clinical outcomes.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0241449
DOI:
10.1371/journal.pone.0241449.g001
DOI:
10.1371/journal.pone.0241449.g002
DOI:
10.1371/journal.pone.0241449.g003
DOI:
10.1371/journal.pone.0241449.t001
DOI:
10.1371/journal.pone.0241449.t002
DOI:
10.1371/journal.pone.0241449.t003
DOI:
10.1371/journal.pone.0241449.s001
DOI:
10.1371/journal.pone.0241449.s002
DOI:
10.1371/journal.pone.0241449.s003
DOI:
10.1371/journal.pone.0241449.s004
DOI:
10.1371/journal.pone.0241449.s005
DOI:
10.1371/journal.pone.0241449.s006
DOI:
10.1371/journal.pone.0241449.s007
DOI:
10.1371/journal.pone.0241449.s008
DOI:
10.1371/journal.pone.0241449.s009
DOI:
10.1371/journal.pone.0241449.s010
DOI:
10.1371/journal.pone.0241449.s011
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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