Korean Circulation Journal

  • 제54권3호
  • /
  • Pages.113-123
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  • 2024
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Clinical Outcomes of Intracardiac Echocardiography-Guided Contrast Agent-Free Cryoballoon Ablation in Atrial Fibrillation Patients With Renal Insufficiency

  • Dong Geum Shin (Division of Cardiology, Hallym University Kangnam Sacred Heart Hospital) ;
  • Jinhee Ahn (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital) ;
  • Sang Hyun Park (Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Sang-Jin Han (Division of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Hong Euy Lim (Division of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 투고 : 2023.07.10
  • 심사 : 2023.10.11
  • 발행 : 2024.03.01
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초록

Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA2DS2-VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions: ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.

키워드

과제정보

This work was supported by the Medtronic Korea and clinical research grant from Hallym University Medical Center (H20200419).

참고문헌

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