title: Associations between renal function, atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Renal dysfunction was reported to be associated with a higher recurrence rate after electric cardioversion of atrial fibrillation (AF). The aim of this study was to investigate the associations between renal function, atrial substrate properties and outcome of catheter ablation in paroxysmal AF patients.
  
  
  RESULTS
  A total of 232 paroxysmal AF patients that underwent catheter ablation were enrolled in the study. The estimated glomerular filtration rate (GFR) was calculated using the Cockcroft-Gaut equation normalized by the body surface area, and the patients were divided into 3 groups according to their GFR (group 1: ≥ 90 ml·min⁻¹·1.73 m⁻², group 2: 60-90 ml·min⁻¹·1.73 m⁻² and group 3: < 60 ml·min⁻¹·1.73 m⁻²). The left atrial (LA) voltage became lower and the activation time longer when the GFR decreased from group 1 to group 3. During a follow up of 25.4 ± 13.3 months, 15.9% of the study population suffered from AF recurrences. The recurrence rates of those 3 groups were 6.9%, 14.5% and 38.9%, respectively. The LA dimension, LA voltage and groups of renal function were identified to be the independent predictors of an AF recurrence in the multivariate analysis.
  
  
  CONCLUSIONS
  A decreased GFR was associated with an abnormal LA substrate and high recurrence rate of catheter ablation in patients with paroxysmal AF.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suenari
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology* / Q000628:therapy; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult