Concomitant chronic kidney disease increases the recurrence of atrial fibrillation after catheter ablation of atrial fibrillation: a mid-term follow-up.

BACKGROUND: Chronic kidney disease (CKD) is often associated with atrial fibrillation (AF). However, its impact on the results of radiofrequency catheter ablation for AF has not been fully examined.
OBJECTIVE: The purpose of this study was to clarify the relationship between CKD and postcatheter ablation AF recurrence.
METHODS: The study included 221 patients with AF who underwent successful catheter ablation. The prevalence and characteristics of AF recurrences were determined. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2).
RESULTS: After mean follow-up of 31.9 ± 7.6 months, 87 (39%) patients had AF recurrences. Multivariate Cox regression analysis revealed that CKD (hazard ratio [HR] 2.089, 95% confidence interval [CI] 1.292-3.378, P <.01) and left atrial volume (HR 1.009, 95% CI 1.002-1.017, P <.05) were independent predictors of AF recurrences. Among the 221 patients, 54 (24.4%) had CKD. Patients with CKD had a higher incidence of AF recurrences (57.4%) compared to the non-CKD patients (33.5%, P <.01). Compared with patients without CKD, patients with CKD were older (64 ± 11 years vs 58 ± 10 years, P <.001) and had a higher prevalence of hypertension (72% vs 53%, P <.05), larger left atrial volume (74.7 ± 29.4 mL vs 62.0 ± 26.0 mL, P <.01), and higher plasma B-type natriuretic peptide levels (129.6 ± 209.3 pg/mL vs 68.8 ± 91.0 pg/mL, P <.01).
CONCLUSION: The presence of CKD increased the risk of AF recurrences after catheter ablation. Multifactorial physiologic factors due to CKD may account for the higher prevalence of recurrent AF in patients with CKD than in those without.