{"id":"7712af0aee5c","type":"article","url":"https://hartvaat.nl/2025/09/01/nierfunctie-en-effectiviteit-van-lva-ablatie-na-pvi-bij-af/","title":"Nierfunctie en effectiviteit van LVA-ablatie na PVI bij AF","title_en":"Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: a sub-analysis of the SUPPRESS-AF trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euaf205","source_url":"https://doi.org/10.1093/europace/euaf205","authors":["Yasuhiro Matsuda","Masaharu Masuda","Toshiaki Mano","Takuya Tsujimura","Hiroyuki Uematsu","Hirotaka Ooka","Satoshi Kudo","Mizuki Ochi","Shin Okamoto","Takayuki Ishihara","Kiyonori Nanto","Yosuke Hata","Sho Nakao","Masaya Kusuda","Wataru Ariyasu","Akihiro Sunaga","Nobuaki Tanaka","Tetsuya Watanabe","Hitoshi Minamiguchi","Yasuyuki Egami","Takafumi Oka","Tomoko Minamisaka","Takashi Kanda","Masato Okada","Masato Kawasaki","Koji Tanaka","Nobuhiko Makino","Hirota Kida","Shungo Hikoso","Tomoharu Dohi","Koichi Inoue","Yohei Sotomi","Yasushi Sakata"],"significance":5,"published":"2025-09-01","source_date":"2025-09-01","image":"","kennis":[],"congress":"","summary_en":"A SUPPRESS-AF substudy investigated whether renal function modifies the efficacy of low-voltage area ablation after pulmonary vein isolation. Kidney function did not significantly influence the benefit of substrate-based ablation.","created":"2026-07-03T10:31:50Z","updated":"2026-07-03T13:30:50Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie onderzocht of nierfunctie de effectiviteit van low-voltage area ablatie na PVI bij AF beïnvloedt. De nierfunctie modificeerde het ablatie-effect niet significant.","abstract_original":"AIMS: The SUPPRESS-AF trial showed that pulmonary vein isolation (PVI) plus low-voltage area (LVA) ablation may reduce atrial fibrillation (AF) recurrence in some subgroups. Renal dysfunction is a cause of LVAs due to atrial cardiomyopathy and is also a risk factor for AF recurrence after catheter ablation. The aim of this study was to investigate the efficacy of LVA ablation after PVI stratified by renal function. METHODS AND RESULTS: This study was a sub-analysis of the SUPPRESS-AF trial, a multicentre, prospective, randomized, open-label trial. A total of 341 consecutive patients who underwent initial radiofrequency catheter ablation for persistent AF and whose LVAs were ≥5 cm2 were analysed. Patients were randomized to PVI alone (PVI-alone group) or LVA ablation after PVI [PVI + LVA-ablation (ABL) group]. Primary outcome was defined as the recurrence of atrial tachyarrhythmias during the 12 months following ablation. Estimated glomerular filtration rate (eGFR) was assessed before ablation, and patients were stratified by chronic kidney disease (CKD) stage. The mean eGFR was 60 ± 16 mL/min/1.73 m2, and 146 (43%) patients developed the primary outcome. In patients with CKD G1-2 (eGFR ≥ 60 mL/min/1.73 m2), freedom from the primary outcome was similar between the PVI + LVA-ABL and PVI-alone groups (53.1% vs. 55.3%, P = 0.59). In contrast, in patients with CKD G3a-5 (eGFR < 60 mL/min/1.73 m2), freedom from the primary outcome was significantly higher in the PVI + LVA-ABL group than in the PVI-alone group (69.1% vs. 43.3%; P = 0.004). CONCLUSION: In patients with renal dysfunction, LVA ablation after PVI reduced AF recurrence after radiofrequency catheter ablation for persistent AF."}