Protective effect of Catheter Ablation of Atrial Fibrillation on the
Renal Function in Patients with Hypertrophic Cardiomyopathy
Abstract
Introduction: Atrial fibrillation (AF) is a common arrhythmia in
patients with hypertrophic cardiomyopathy (HCM) and is associated with
renal function deterioration. The protective effects of catheter
ablation (CA) of AF on the renal function in HCM patients remains
unsolved. Methods: From 2009 to 2020, 169 consecutive patients with HCM
and AF (age 70±12, 87 males) were retrospectively evaluated. The
estimated glomerular filtration rate (eGFR) was evaluated at the study
enrollment or one month before the CA and reevaluated three months and
12 months later. Results: Among the 169 patients, 63 underwent CA of AF
(ablation group) and the remaining 106 did not (control group). After
propensity score matching, 45 pairs were matched. The baseline eGFR was
similar between the two groups (P=0.83). During a mean follow-up period
of 34±27 months, sinus rhythm was maintained in 36 (80%) patients after
1.7±0.8 ablation procedures. The eGFR significantly decreased from
baseline to three months (P<0.01) and from baseline to one
year (P<0.01) in the control group, while the eGFR in the
ablation group was maintained both from baseline to three months
(P=0.94) and from baseline to one year (P=1.00) after the CA. The change
in the eGFR between baseline and 12 months was significantly smaller in
the ablation group than control group (P<0.01). After a
logistic regression analysis, CA of AF was the independent predictor of
an improvement of eGFR (OR: 2.81; 95% CI: 1.08-7.36 P=0.04).
Conclusions: CA of AF had a protective effect on the renal function in
patients with HCM.