Arrhythmias & electrophysiologyResearch article
Safety and Efficacy of Pulsed Field Ablation for Atrial Fibrillation in Patients With Chronic Kidney Disease
- Consecutive patients from a major health system in the United States
Authors' conclusion
PFA for AF is feasible in patients with CKD. However, patients with a decreased eGFR had a significantly higher risk of AKI and presented a numerically higher rate of non-renal complications.
Study context
- Population
- Patients undergoing pulsed field ablation for atrial fibrillation (AF), with and without chronic kidney disease (CKD), from a major health system in the United Statespatients included · without CKD 1,829 · mild CKD 314 · moderate CKD 103 · advanced CKD 23
- Participants
- 2,269 patients
- Comparison
- Pulsed field ablation (PFA) for AF in patients with and without CKD
- no CKDn = 1,829
- mild CKDn = 314
- moderate CKDn = 103
- advanced CKDn = 23
Main finding
As reported in the abstract
Non-renal procedural complications
Non-renal procedural complications, all patients
5.9%
Further findings
Acute kidney injury (AKI)
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| decreased eGFR · decreased eGFR independently associated with AKI | 0.96 (0.94–0.99) | P < 0.01 | |
| 0.512Odds ratio (log scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Estimated 12-month AF-free survival · comparable | 1.20 (0.93–1.59) | P = 0.1 | |
| 0.512Hazard ratio (log scale) |
- AKI — AKI among patients with available post-procedural renal function data
- 4.9%
Baseline characteristics
- Mean age (years)
- 66.9 (±10.2)
- Female patients
- 716 (31.6%)
Original publication
Safety and Efficacy of Pulsed Field Ablation for Atrial Fibrillation in Patients With Chronic Kidney Disease. Heart Rhythm. Published 6 October 2026. doi:10.1016/j.hrthm.2026.09.053
Summarised from the published abstract; every number is checked against it