Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
Safety and efficacy of atrial fibrillation ablation in kidney transplant patients.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Keelani Ahmad, Bartoli Lorenzo, Gasperetti Alessio, Popescu Sorin, Schiavone Marco, Traub Anna, Phan Huong-Lan, Feher Marcel, Fink Thomas, Sciacca Vanessa, Nitschke Martin, Vogler Julia, Eitel Charlotte, Forleo Giovanni, Heeger Christian-H, Tilz Roland R
Аннотация
INTRODUCTION: Managing atrial fibrillation in kidney transplant patients poses a challenge for both nephrologists and cardiologists. Data regarding the safety and efficacy of catheter ablation in this patient's cohort is scarce.
METHODS AND RESULTS: In this two-center prospective study, we included all consecutive kidney transplant patients who underwent atrial fibrillation ablation between April 2017 and March 2022. A 1:3 propensity score matching created a control group of non-transplant AF patients undergoing ablation. We included 16 kidney transplant patients and 48 matched controls. Ablation was successful in all patients. The periprocedural complication rate (6.3% in the kidney transplant group vs. 6.3% in the control group, p value = 1) did not differ between the two groups. One transplant patient experienced graft dysfunction after a complication. At 18 months, AF recurrence-fee rates were 69% in the transplant group and 70.1% in controls (p = 0.95). By the last follow-up, all transplant patients had discontinued antiarrhythmic drugs, while 19.6% of the patients in the control group were treated with antiarrhythmic drugs (p = 0.09). Kidney function in the transplant group remained stable (eGFR 32 [23.8, 40.5] ml/min/1.73 m2 before vs. 34 [29.8, 38] ml/min/1.73 m2 at last follow up, p = 0.93).
CONCLUSIONS: This study demonstrates that catheter ablation is a viable option for treating AF in kidney transplant patients, with comparable outcomes to non-transplanted individuals. Discontinuing antiarrhythmic drugs reduces drug interaction risks, but minimizing procedural complications remains critical to preserving graft function.
METHODS AND RESULTS: In this two-center prospective study, we included all consecutive kidney transplant patients who underwent atrial fibrillation ablation between April 2017 and March 2022. A 1:3 propensity score matching created a control group of non-transplant AF patients undergoing ablation. We included 16 kidney transplant patients and 48 matched controls. Ablation was successful in all patients. The periprocedural complication rate (6.3% in the kidney transplant group vs. 6.3% in the control group, p value = 1) did not differ between the two groups. One transplant patient experienced graft dysfunction after a complication. At 18 months, AF recurrence-fee rates were 69% in the transplant group and 70.1% in controls (p = 0.95). By the last follow-up, all transplant patients had discontinued antiarrhythmic drugs, while 19.6% of the patients in the control group were treated with antiarrhythmic drugs (p = 0.09). Kidney function in the transplant group remained stable (eGFR 32 [23.8, 40.5] ml/min/1.73 m2 before vs. 34 [29.8, 38] ml/min/1.73 m2 at last follow up, p = 0.93).
CONCLUSIONS: This study demonstrates that catheter ablation is a viable option for treating AF in kidney transplant patients, with comparable outcomes to non-transplanted individuals. Discontinuing antiarrhythmic drugs reduces drug interaction risks, but minimizing procedural complications remains critical to preserving graft function.