The impact of haemodialysis on the outcomes of catheter ablation in patients with paroxysmal atrial fibrillation

作者：Takigawa Masateru^*; Kuwahara Taishi; Takahashi Atsushi; Kobori Atsushi; Takahashi Yoshihide; Okubo Kenji; Watari Yuji; Sugiyama Tomoyo; Kimura Shigeki; Takagi Katsumasa; Hikita Hiroyuki; Hirao Kenzo; Isobe Mitsuaki

来源：Europace, 2014, 16(3): 327-334.

DOI：10.1093/europace/eut230

• Atrial fibrillation
• Haemodialysis
• Catheter ablation
• Recurrence
• Prognosis

The outcomes of catheter ablation (CA) in patients with paroxysmal atrial fibrillation (PAF) who are undergoing haemodialysis (HD) have not been fully elucidated. This study aimed to determine the impact of HD on CA outcome in these patients. %26lt;br%26gt;We examined 1364 consecutive PAF patients (mean age, 61 10 years) who underwent CA, including 32 (2.3) patients undergoing HD. The patients undergoing HD had a significantly lower body mass index (P 0.0001), higher CHADS(2) score (P 0.006), and higher prevalence of structural heart disease (P 0.0001), hypertension (P 0.002), and congestive heart failure (P 0.02). Echocardiography indicated a larger left atrial diameter (P 0.0001) and left ventricular diameter (P 0.0002) in the HD patients. Haemodialysis was a significant predictor of AF recurrence (hazard ratio 2.56; 95 confidence interval 1.564.03; P 0.0004) in the overall population. Sinus rhythm maintenance rates in the HD patients at 1, 3, and 5 years were 42.3, 37.6, and 19.7, respectively, after the first procedure, and 64.7, 54.9, and 47.1, respectively, after the final procedure (median, 2; range, 12 procedures); these rates were significantly lower than those in the non-HD patients (P 0.0001). The 5-year survival rate was 78.1 in the HD patients. %26lt;br%26gt;Haemodialysis was significantly associated with AF recurrence after CA for PAF. However, an 50 success rate for sinus rhythm maintenance without antiarrhythmic drug therapy in HD patients suggested that CA could be an option for the treatment of AF.

• 出版日期2014-3