Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Heart Rhythm. 2011 Mar;8(3):335-41. doi: 10.1016/j.hrthm.2010.10.047. Epub 2010 Nov 4.
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.
The purpose of this study was to clarify the relationship between CKD and postcatheter ablation AF recurrence.
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).
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).
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.
慢性肾脏病（CKD）常与心房颤动（AF）相关。然而，其对射频导管消融治疗 AF 结果的影响尚未得到充分研究。
本研究旨在阐明 CKD 与导管消融后 AF 复发之间的关系。
研究纳入 221 例成功接受导管消融的 AF 患者。确定 AF 复发的发生率和特征。CKD 定义为估算肾小球滤过率<60 mL/min/1.73 m²。
平均随访 31.9±7.6 个月后，87 例（39%）患者发生 AF 复发。多变量 Cox 回归分析显示，CKD（风险比[HR]2.089，95%置信区间[CI]1.292-3.378，P<.01）和左心房容积（HR 1.009，95%CI 1.002-1.017，P<.05）是 AF 复发的独立预测因素。在 221 例患者中，54 例（24.4%）患有 CKD。CKD 患者 AF 复发发生率（57.4%）高于非 CKD 患者（33.5%，P<.01）。与无 CKD 患者相比，CKD 患者年龄更大（64±11 岁 vs 58±10 岁，P<.001），高血压患病率更高（72% vs 53%，P<.05），左心房容积更大（74.7±29.4 mL vs 62.0±26.0 mL，P<.01），血浆 B 型利钠肽水平更高（129.6±209.3 pg/mL vs 68.8±91.0 pg/mL，P<.01）。
存在 CKD 会增加导管消融后 AF 复发的风险。由于 CKD 导致的多种生理因素可能是 CKD 患者 AF 复发率高于无 CKD 患者的原因。
