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Boriani G, Iacopino S, Arena G, Pieragnoli P, Verlato R, Manfrin M, Molon G, Rovaris G, Curnis A, Perego GB, Dello Russo A, Landolina M, Vitolo M, Tondo C. Chronic Kidney Disease with Mild and Mild to Moderate Reduction in Renal Function and Long-Term Recurrences of Atrial Fibrillation after Pulmonary Vein Cryoballoon Ablation. J Cardiovasc Dev Dis 2022; 9:jcdd9050126. [PMID: 35621837 PMCID: PMC9147782 DOI: 10.3390/jcdd9050126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this research was to evaluate if patients with chronic kidney disease (CKD) and mild or mild to moderate depression of renal function have an increased risk of atrial fibrillation (AF) recurrences after cryoballoon (CB) ablation. We performed a retrospective analysis of AF patients undergoing pulmonary vein isolation (PVI) by CB. The cohort was divided according to the KDIGO CKD-EPI classification into a (1) normal, (2) mildly decreased, or (3) mild to moderate reduction in estimated glomerular filtration rate (eGFR). Freedom from AF recurrences was the primary endpoint. A total of 1971 patients were included (60 ± 10 years, 29.0% females, 73.6% paroxysmal AF) in the study. Acute success and complication rates were 99.2% and 3.7%, respectively, with no significant differences among the three groups. After a follow-up of 24 months, AF recurrences were higher in the mildly and mild to moderate CKD groups compared to the normal kidney function group (23.4% vs. 28.3% vs. 33.5%, p < 0.05). Mild to moderate CKD was an independent predictor of AF recurrences after the blanking period (hazard ratio:1.38, 95% CI 1.02−1.86, p = 0.037). In conclusion, a multicenter analysis of AF patients treated with cryoablation revealed mild to moderate reductions in renal functions were associated with a higher risk of AF recurrences. Conversely, the procedural success and complication rates were similar in patients with normal, mildly reduced, or mild to moderate reduction in eGFR.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy;
- Correspondence:
| | - Saverio Iacopino
- Electrophysiology Unit, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy;
| | | | | | - Roberto Verlato
- ULSS 6 Euganea, Ospedale di Camposampiero-Cittadella, 35013 Cittadella, Italy;
| | | | - Giulio Molon
- IRCCS Sacro Cuore don Calabria, 37024 Negrar, Italy;
| | | | | | | | | | | | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Claudio Tondo
- Department of Clinical Electrophysiology & Cardiac Pacing, Heart Rhythm Center, Monzino Cardiac Center IRCCS, 20122 Milan, Italy;
- Department of Biochemical, Surgical and Dentist Sciences, University of Milan, 20122 Milan, Italy
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