医学
心脏病学
内科学
急性肾损伤
导管消融
烧蚀
心房颤动
肾脏疾病
导管
射频消融术
作者
Ling Kuo,Daniele Muser,Yasuhiro Shirai,Aung Lin,Jackson J. Liang,Robert D. Schaller,Matthew C. Hyman,Ramanan Kumareswaran,Jeffrey Arkles,Gregory E. Supple,David S. Frankel,Fermin C. Garcia,Cory M. Tschabrunn,Saman Nazarian,Sanjay Dixit,David Lin,Michael P. Riley,David J. Callans,Rajat Deo,Andrew E. Epstein,Erica S. Zado,Francis E. Marchlinski,Pasquale Santangeli
标识
DOI:10.1016/j.jacep.2020.08.018
摘要
Abstract Objectives This study sought to examine the impact of periprocedural acute kidney injury (AKI) in scar-related ventricular tachycardia (VT) patients undergoing radiofrequency catheter ablation (RFCA) on short- and long-term outcomes. Background The clinical significance of periprocedural AKI in patients with scar-related VT undergoing RFCA has not been previously investigated. Methods This study included 317 consecutive patients with scar-related VT undergoing RFCA (age: 64 ± 13 years, mean left ventricular ejection fraction: 33 ± 13%, 55% ischemic cardiomyopathy). Periprocedural AKI was defined as an absolute increase in creatinine of ≥0.3 mg/dl over 48 h or an increase of >1.5× the baseline values within 1 week post-procedure. Results Periprocedural AKI occurred in 31 patients (10%). Independent predictors of AKI included chronic kidney disease (odds ratio [OR]: 3.43; 95% confidence interval [CI]: 1.48 to 7.96; p = 0.004), atrial fibrillation (OR: 2.42; 95% CI: 1.01 to 5.78; p = 0.047), and peri-procedural acute hemodynamic decompensation (OR: 3.98; 95% CI: 1.17 to 13.52; p = 0.003). After a median follow-up of 39 months (interquartile range: 6 to 65 months), 95 patients (30%) died. Periprocedural AKI was associated with increased risk of early mortality (within 30 days; hazard ratio [HR]: 9.91; 95% CI: 2.87 to 34.22; p Conclusions Periprocedural AKI occurs in 10% of patients undergoing RFCA of scar-related VT and is strongly associated with increased risk of early and late post-procedural mortality.
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