长时程持续性房颤复发后再次消融患者:低CHA2DS2-VASc评分和窦性心律对改善的肾功能具有预测作用
长时程持续性房颤复发后再次消融患者:低CHA2DS2-VASc评分和窦性心律对改善的肾功能具有预测作用
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发表时间：
2016
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通讯作者：
Y.-Q. Yang
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作者：
Q. Wang;X.-D. Zhang;X. Liu;Y.-Q. Yang
Background. Renal impairment and atrial fibrillation (AF) often coexist. Catheter ablation is an effective way to reduce the burden of AF and improve symptoms; however, little is known about the relationship between renal function and AF and its role in the progression of AF for patients undergoing repeat catheter ablation..Methods. In all,171 patients with long-standing persistent AF ablation were enrolled in the study. The patients were divided in-.to two groups according to their delta estimated glomerular filtration rate (eGFR) values, which was defined as the eGFR before the repeat procedure minus the eGFR before the initial procedure. Patients with decreasing eGFR (delta eGFR < 0) were categorized as group I, while individuals with no change or increasing eGFR (delta eGFR≥ 0) were categorized as group II. eGFR was estimated at baseline and at the 12-month and 24-month follow-up visits..Results. After a mean follow-up of.31.4 ± 13.2 months, group I had a significantly higher arrhythmia recurrence rate than group II (71.2 vs. 49.2 %, p < 0.001). On multivariable analyses, eGFR changes after the repeat procedure were associated with arrhythmia recurrence, hypertrophic cardio- myopathy, and CHA2DS2-VASc score. Patients with arrhythmia recurrence and those with a.CHA2DS2-VASc score of ≥ 3 were more likely to show an eGFR decline at follow-up. Conclusion. Patients with long-standing persistent AF, with a failed initial ablation procedure and undergoing a repeat ablation procedure, appear to have a higher risk of arrhythmia recurrence. During the follow-up period, patients without arrhythmia recurrence and those with a CHA2DS2-VASc score of < 3 show improved renal function.
