Medical Research: What are the main findings of the study?
Dr. Komej: Both atrial fibrillation (AF) and renal impairment are known to coexist and associated with increased morbidity and mortality. However, there is only limited data on changes of renal function after AF catheter ablation and predictors thereof. This is the largest study analyzing the effects of atrial fibrillation catheter ablation on renal function and changes thereof in a contemporary population during mid-term follow-up. We found that lower baseline eGFR was associated with higher CHADS2 and CHA2DS2-VASc scores and that both scores were independently associated with eGFR changes after atrial fibrillation catheter ablation as were atrial fibrillation recurrences.
Medical Research: What was most surprising about the results?
Dr. Komej: CHADS2 and CHA2DS2-VASc scores are associated not only with thromboembolic risk but also – as we have shown in the current study – with eGFR changes in atrial fibrillation patients after catheter ablation. Furthermore, patients with atrial fibrillation recurrence were more likely to show an eGFR decline during follow-up. The later funding indicates the necessity for better control of atrial fibrillation recurrences – as a possible marker for atrial fibrillation progression and modulator for other outcomes (e.g. impairment in renal function), supporting the idea of optimal and regular follow-up after AF catheter ablation and attempts to restore sinus rhythm.
Medical Research: What should clinicians and patients take away from your report?
Dr. Komej: Better control of atrial fibrillation recurrences – as a possible marker for AF progression and modulator for other outcomes (e.g. impairment in renal function) – is an important finding, supporting the idea of optimal and regular follow-up after atrial fibrillation catheter ablation and attempts to restore sinus rhythm.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Komej: The cause–effect relationship or even parallel phenomena in patients with atrial fibrillation and renal dysfunction remain elusive. Therefore, further prospective studies are required to confirm whether catheter ablation had an impact on eGFR changes. As long as AF recurrences could be asymptomatic and under-detected, further studies with continuous rhythm control during long-term follow-up are needed to confirm our findings.
Changes in renal function after catheter ablation of atrial fibrillation are associated with CHADS2 and CHA2DS2-VASc scores and arrhythmia recurrences
Jelena Kornej, Gerhard Hindricks, Amitava Banerjee, Arash Arya, Philipp Sommer, Sascha Rolf, Daniela Husser, Gregory Y H Lip, Andreas Bollmann
Heart heartjnl-2014-306013Published Online First: 3 October 2014 doi:10.1136/heartjnl-2014-306013