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- Title
Efficacy and safety of radiofrequency catheter ablation for atrial fibrillation in chronic hemodialysis patients.
- Authors
Hayashi, Motoharu; Kaneko, Shinji; Shimano, Masayuki; Ohashi, Taiki; Kubota, Ryuji; Takeshita, Kyosuke; Shinoda, Masanori; Inden, Yasuya; Kanayama, Hitoshi; Murohara, Toyoaki
- Abstract
Background Radiofrequency catheter ablation (RFCA) is increasingly performed for the treatment of atrial fibrillation (AF), but it is problematic because the use of anti-arrhythmic agents is largely restricted in patients undergoing hemodialysis (HD) therapy. However, little is known about the long-term clinical outcomes of AF after RFCA in HD patients. Methods Between 2002 and 2008, 16 HD patients (age: 63.8 ± 7.4 years, 75.0% men) underwent RFCA for AF at the Toyota Kosei Hospital. We investigated the long-term results and mortality of RFCA for AF in HD patients and compared them with those of 111 non-HD patients (age: 58.6 ± 10.0 years, 78.3% male) who received the same procedures. Results During the follow-up (64.3 ± 25.4 months in HD patients, 70.5 ± 20.2 months in non-HD patients) after the initial RFCA procedure, sinus rhythm was restored in 4 HD patients (25%) and in 45 non-HD patients (40.5%). Multiple procedures were performed in 12 HD patients and in 57 non-HD patients. After the final procedure, 13 HD patients (81.3%) and 92 non-HD patients (82.9%) were free of atrial arrhythmia and symptoms. Of importance, Kaplan–Meier analysis did not demonstrate any significant differences in the atrial arrhythmia-free rate after the last procedure between HD patients and the control group matched after propensity-score analysis despite higher all-cause mortality in HD patients than in non-HD patients. Conclusions During 5-years of follow-up, the use of multiple RFCA procedures for AF in patients undergoing HD was favorable, whereas the use of a single procedure was disappointing. Multiple RFCA procedures can be an efficient approach to the treatment of AF in HD patients.
- Subjects
RADIO frequency; CATHETER ablation; ATRIAL fibrillation; HEMODIALYSIS patients; BACKGROUND radiation; MYOCARDIAL depressants; MORTALITY
- Publication
Nephrology Dialysis Transplantation, 2014, Vol 29, Issue 1, p160
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gft233