Key result
Renal dysfunction following cardioversion of atrial fibrillation (AFCARD) was associated with a significantly decreased 1-year survival rate compared to patients without AFCARD (63% vs 92%; p<0.001).
Why the study?
Does the development of renal dysfunction following cardioversion of atrial fibrillation affect 1-year survival?
Case-Control (n=112)
No
Does the development of renal dysfunction following cardioversion of atrial fibrillation affect 1-year survival?
Renal dysfunction following direct current cardioversion for atrial fibrillation is relatively common (17%) and is associated with significantly reduced 1-year survival, suggesting a need for close post-procedural renal surveillance.
Answers are grounded in this paper and cite their sources.
AFCARD may warrant post-cardioversion renal surveillance in AF; leaves open causality and need for prospective validation.
OBJECTIVE: Limited data are available regarding the incidence and clinical impact of renal dysfunction following cardioversion of atrial fibrillation. The objective of this study was to assess the incidence and implications of renal dysfunction following cardioversion of atrial fibrillation. METHODS: We conducted a nested case-control study to determine the incidence, timing, risk factors and outcome of atrial fibrillation cardioversion associated with renal dysfunction (AFCARD) in a tertiary medical center. Consecutive patients undergoing direct current cardioversion (DCCV) for atrial fibrillation in our institution during 2008-2009 with measurements of creatinine before and following cardioversion were included. AFCARD was defined as a rise in serum creatinine greater than 25% from baseline within a week following DCCV. RESULTS: One hundred and twelve patients were included in the study, of whom 19 (17%) developed AFCARD. One patient required hemodialysis. Patients with AFCARD had a higher incidence of advanced heart failure, diabetes mellitus and were more frequently treated with digoxin and enoxaparin. Patients with AFCARD had a significantly decreased survival rate at 1 year (63 vs. 92%; p < 0.001). CONCLUSIONS: AFCARD is relatively common and is associated with increased mortality. These findings suggest a role for close surveillance of renal function following DCCV.
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Hellman et al. (2013) conducted a case-control in Atrial fibrillation (n=112). Renal dysfunction following cardioversion (AFCARD) vs. No renal dysfunction following cardioversion was evaluated on Survival rate at 1 year (p=< 0.001). Renal dysfunction following cardioversion of atrial fibrillation (AFCARD) was associated with a significantly decreased 1-year survival rate compared to patients without AFCARD (63% vs 92%; p<0.001).
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