title: Changes in renal function after catheter ablation of atrial fibrillation are associated with CHADS2 and CHA2DS2-VASc scores and arrhythmia recurrences.
abstract: BACKGROUND
  Renal impairment is associated with poor prognosis in the setting of atrial fibrillation (AF). While AF catheter ablation is an effective treatment modality for AF burden reduction and improvement of symptoms, changes in renal function after catheter ablation and their association with rhythm outcome have not been studied in a large contemporary AF ablation cohort.
  
  
  OBJECTIVE
  To determine the association between CHADS2 and CHA2DS2-VASc scores and arrhythmia recurrences with changes in renal function following AF catheter ablation.
  
  
  METHODS
  Estimated glomerular filtration rate (eGFR) was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation at baseline and during follow-up in 783 patients undergoing de novo AF catheter ablation. Complete rhythm follow-up was achieved in 626 patients (80%) using serial 7-day Holter ECG.
  
  
  RESULTS
  The study population (n=783, 61±10 years, 64% men, 57% paroxysmal AF) was followed up at median 20 (IQR 12-27) months. Baseline eGFR correlated with CHADS2 (β=-0.258, p<0.001) and CHA2DS2-VASc scores (β=-0.434, p<0.001). On multivariable analyses, eGFR changes were associated with AF recurrences (B=-0.136, p=0.014), CHADS2 (B=-0.062, p=0.035) and CHA2DS2-VASc scores (B=-0.057, p=0.003).
  
  
  CONCLUSIONS
  In patients after AF catheter ablation, eGFR changes during mid-term follow-up are associated with AF recurrences, CHADS2 and CHA2DS2-VASc scores.
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany Centre for Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK.
authors.forename: Jelena
authors.identifier: http://orcid.org/0000-0003-3551-1145
authors.initials: J
authors.lastname: Kornej
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Centre for Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK.
authors.forename: Amitava
authors.initials: A
authors.lastname: Banerjee
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.affiliation: Centre for Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D003661:Decision Support Techniques; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D012008:Recurrence; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome