Address for correspondence:
Hiroshi Hayashi, M.D., PhD.
Department of Cardiovascular Medicine, Nippon Medical School
1-1-5 Sendagi, Bunkyo-ku
Tokyo, 113-8603, Japan
Phone: 81-3-3822-2131 (Ext 24007)
Fax: 81-3-5685-0987
E-mail: s00-067@nms.ac.jp
Funding statement: (None)
Conflict of interest disclosures: (None)Abstract
Introduction:
Atrial fibrillation (AF) is a common arrhythmia in patients with
hypertrophic cardiomyopathy (HCM) and is associated with renal function
deterioration. The protective effects of catheter ablation (CA) of AF on
the renal function in HCM patients remains unsolved.
Methods: From 2009 to 2020, 169 consecutive patients
with HCM and AF (age 70±12, 87 males) were retrospectively evaluated.
The estimated glomerular filtration rate (eGFR) was evaluated at the
study enrollment or one month before the CA and reevaluated three months
and 12 months later.
Results: Among the 169 patients, 63 underwent CA of AF
(ablation group) and the remaining 106 did not (control group). After
propensity score matching, 45 pairs were matched. The baseline eGFR was
similar between the two groups (P=0.83). During a mean follow-up period
of 34±27 months, sinus rhythm was maintained in 36 (80%) patients after
1.7±0.8 ablation procedures. The eGFR significantly decreased from
baseline to three months (P<0.01) and from baseline to one
year (P<0.01) in the control group, while the eGFR in the
ablation group was maintained both from baseline to three months
(P=0.94) and from baseline to one year (P=1.00) after the CA. The change
in the eGFR between baseline and 12 months was significantly smaller in
the ablation group than control group (P<0.01). After a
logistic regression analysis, CA of AF was the independent predictor of
an improvement of eGFR (OR: 2.81; 95% CI: 1.08-7.36 P=0.04).
Conclusions: CA of AF had a protective effect on the
renal function in patients with HCM.