Improvement of Renal Function in Atrial Fibrillation Patients via Catheter Ablation and Left Atrial Appendage Closure: A Case Report.

BACKGROUND Atrial fibrillation (AF) is a common arrhythmia that often coexists with heart failure and chronic kidney disease (CKD). Approximately 30% of patients with AF have CKD, and this comorbidity not only increases the complexity of treatment but also limits the choice of anticoagulant drugs. In clinical practice, the treatment strategy for these patients needs to balance cardiac and renal functions comprehensively. CASE REPORT This article reports a case of a 69-year-old woman with persistent AF and stage G3a CKD complicated by acute kidney injury (AKI on CKD). Upon admission, the patient's estimated glomerular filtration rate (eGFR) was 7.47 mL/min/1.73 m². The patient received standard heart failure treatment and underwent catheter ablation for AF, combined with left atrial appendage closure, which successfully restored sinus rhythm. Follow-up examinations showed a significant improvement in the patient's eGFR to 22.57 mL/min/1.73 m². During the postoperative hospital stay, the patient initially received anticoagulation with subcutaneous enoxaparin injection for 2 days. After discharge on day 3, the patient was switched to oral warfarin, with the international normalized ratio remaining between 2 and 3. On day 6 after the surgery, the patient's eGFR increased to 36.84 mL/min/1.73 m². CONCLUSIONS This case emphasizes the potential of this treatment method in significantly improving renal dysfunction in patients with atrial fibrillation complicated with heart failure and CKD. It underscores the importance of a comprehensive strategy to improve cardiorenal interaction, providing valuable insights for future research and clinical practice.