title: The incidence and prognosis of renal dysfunction following cardioversion of atrial fibrillation.
abstract: 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.
authors.affiliation: Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Hellman
authors.forename: Matan J
authors.initials: MJ
authors.lastname: Cohen
authors.forename: David
authors.initials: D
authors.lastname: Leibowitz
authors.forename: Sasa
authors.initials: S
authors.lastname: Loncar
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.forename: Yosef S
authors.initials: YS
authors.lastname: Haviv
authors.forename: Guy
authors.initials: G
authors.lastname: Haber
authors.forename: Mohamad
authors.initials: M
authors.lastname: Afifi
authors.forename: Shimon
authors.initials: S
authors.lastname: Rosenheck
authors.forename: Chaim
authors.initials: C
authors.lastname: Lotan
authors.forename: Arthur
authors.initials: A
authors.lastname: Pollak
authors.forename: Dan
authors.initials: D
authors.lastname: Gilon
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D016022:Case-Control Studies; D004554:Electric Countershock / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis