Outcomes of ablation of paroxysmal atrial fibrillation in patients on chronic hemodialysis.
BACKGROUND
It is not common for patients on chronic hemodialysis (HD) to undergo catheter ablation of atrial fibrillation (AF). We aimed to show the outcomes of AF ablation in the HD patients.


RESULTS
Thirty HD patients who underwent pulmonary vein (PV) isolation for drug refractory paroxysmal AF were retrospectively studied, and their AF recurrence free rate and frequency of periprocedural complications were compared to 60 age- and gender-matched control patients not requiring HD. A nonirrigated ablation catheter was used in both patient groups. During a mean follow-up period of 821 ± 218 days, 16 (54%) of the HD patients remained free from AF recurrence without any antiarrhythmic agents versus 47 (78%) of the control patients with an initial ablation (P = 0.013). A second ablation procedure was performed in 12 patients with an AF recurrence, and consequently 20 (67%) of the HD patients were in sinus rhythm compared to 53 (88%) of the controls during a follow-up duration of 747 ± 221 after the last ablation (P = 0.012). Bleeding from the venipuncture site requiring a prolonged hospital stay was identified in 2 HD patients and 1 control subject, while no life-threatening complications were observed in either patient group.


CONCLUSIONS
Although the success rate of the PV isolation in HD patients was far from satisfactory, it may be considered as one of the therapeutic options for them.
Department of Cardiology, Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan. rjrgw059@ybb.ne.jp
Akinori
A
Sairaku
Yukihiko
Y
Yoshida
Hiroki
H
Kamiya
Yasushi
Y
Tatematsu
Mamoru
M
Nanasato
Haruo
H
Hirayama
Yukiko
Y
Nakano
Yasuki
Y
Kihara
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D006435:Renal Dialysis; D016896:Treatment Outcome