Relationship between renal function and the risk of recurrent atrial fibrillation following catheter ablation

Background Although several clinical variables are associated with the recurrence of atrial fibrillation (AF) following catheter ablation, the influence of renal function remains to be determined. Objective To evaluate the association of renal function with the outcome of the paroxysmal AF ablation. Methods 224 patients underwent catheter ablation for paroxysmal AF. The relationship between the pre-procedural clinical valuables and ablation outcomes was evaluated. Results Over the course of 37.4 +/- 24.4 months of follow-up of catheter ablation procedures for AF (mean number of procedures 1.33 +/- 0.45), 91.1% of patients (204/224) became free from AF without antiarrhythmic drugs. The estimated glomerular filtration rate (eGFR) was lower in patients with recurrent AF than in those without recurrence (66.6 +/- 17.5 vs 78.4 +/- 16.8 ml/min/1.73 m(2), p=0.003). AF recurred more frequently in patients with low eGFR (< 60 ml/min/1.73 m(2)) than in those with high eGFR (> 60 ml/min/1.73 m(2); 24.3% vs 6.7%, p=0.006). Among the various clinical factors, low eGFR (p=0.02) and left atrium (LA) dilatation (p=0.002) independently predicted the clinical outcome of ablation in patients with paroxysmal AF. Conclusion Low eGFR and LA dilatation independently influence the outcome of catheter ablation for paroxysmal AF.