Key result
Mild to moderate chronic kidney disease was associated with a higher risk of atrial fibrillation recurrences after cryoballoon ablation compared to normal kidney function (HR 1.38; 95% CI 1.02-1.86; p=0.037).
Why the study?
It was unclear whether patients with chronic kidney disease and mild or mild to moderate renal function reduction have an increased risk of atrial fibrillation recurrences after cryoballoon ablation.
Does mild to moderate reduction in renal function increase the risk of AF recurrences in patients undergoing pulmonary vein cryoballoon ablation?
Cohort (n=1,971)
Yes
Does mild to moderate reduction in renal function increase the risk of AF recurrences in patients undergoing pulmonary vein cryoballoon ablation?
Mild to moderate reduction in renal function is associated with a higher risk of AF recurrences after cryoballoon ablation, despite similar procedural success and complication rates.
Mild-moderate CKD warrants closer post-ablation surveillance; leaves open whether renal impairment independently modifies cryoballoon outcomes in randomized settings.
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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Boriani et al. (2022) conducted a cohort in Atrial fibrillation (n=1,971). Mild to moderate chronic kidney disease vs. Normal kidney function was evaluated on Freedom from AF recurrences (HR 1.38, 95% CI 1.02-1.86, p=0.037). Mild to moderate chronic kidney disease was associated with a higher risk of atrial fibrillation recurrences after cryoballoon ablation compared to normal kidney function (HR 1.38; 95% CI 1.02-1.86; p=0.037).
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