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Incidence, risk factors, and clinical outcomes of atrial fibrillation and atrial flutter after heart transplantation.
Am J Cardiol. 2010 Sep 01; 106(5):737-41.AJ

Abstract

Atrial fibrillation (AF) and atrial flutter (AFL) after heart transplantation (HT) has been associated with increased mortality. Diverse incidence rates have been reported to date, with no clear classification according to the time of onset of such arrhythmias. We determined the incidence of AF/AFL using the time of onset after HT and analyzed the associated risk factors and outcomes. We performed a retrospective study of 228 HT recipients (March 1996 to July 2007), including donor and recipient demographics, gender mismatch, ischemia time, surgical anastomosis, time of onset of AF/AFL, acute cellular rejection, left ventricular systolic function, and all-cause mortality. The mean age of the donors (81% men) was 30 +/- 12 years and of the recipients (78% men) was 53 +/- 11 years. AF/AFL occurred in 45 patients (20%): 24 (11%) in the first 30 days, 10 (4%) within the 31 days to 1 year, and 11 (5%) after 1 year. When the patients with AF/AFL were compared to those with sinus rhythm, the significant difference was the older mean age of the donors (p = 0.001) and the recipients (p = 0.02). The all-cause mortality rate was 43% for those with AF/AFL compared to 23% for those with sinus rhythm (hazard ratio 2.45; 95% confidence interval 1.2 to 4.8), mostly driven by the greater mortality in the later-onset AF/AFL group (>30 days after HT). In conclusion, AF and AFL have an incidence of 20% after HT and are associated with increased overall mortality compared to that in patients in sinus rhythm. AF/AFL is more common within the first 30 days of HT, with an overall incidence of 20%. Older donor and recipient age is a risk factor associated with AF/AFL.

Authors+Show Affiliations

Loyola University Medical Center, Maywood, Illinois, USA. dasaritarun@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20723655

Citation

Dasari, Tarun W., et al. "Incidence, Risk Factors, and Clinical Outcomes of Atrial Fibrillation and Atrial Flutter After Heart Transplantation." The American Journal of Cardiology, vol. 106, no. 5, 2010, pp. 737-41.
Dasari TW, Pavlovic-Surjancev B, Patel N, et al. Incidence, risk factors, and clinical outcomes of atrial fibrillation and atrial flutter after heart transplantation. Am J Cardiol. 2010;106(5):737-41.
Dasari, T. W., Pavlovic-Surjancev, B., Patel, N., Williams, A. A., Ezidinma, P., Rupani, A., Sinacore, J. L., & Heroux, A. L. (2010). Incidence, risk factors, and clinical outcomes of atrial fibrillation and atrial flutter after heart transplantation. The American Journal of Cardiology, 106(5), 737-41. https://doi.org/10.1016/j.amjcard.2010.04.035
Dasari TW, et al. Incidence, Risk Factors, and Clinical Outcomes of Atrial Fibrillation and Atrial Flutter After Heart Transplantation. Am J Cardiol. 2010 Sep 1;106(5):737-41. PubMed PMID: 20723655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence, risk factors, and clinical outcomes of atrial fibrillation and atrial flutter after heart transplantation. AU - Dasari,Tarun W, AU - Pavlovic-Surjancev,Biljana, AU - Patel,Nilamkumar, AU - Williams,Alexis A, AU - Ezidinma,Phoebe, AU - Rupani,Arti, AU - Sinacore,James L, AU - Heroux,Alain L, Y1 - 2010/07/23/ PY - 2010/02/24/received PY - 2010/04/20/revised PY - 2010/04/20/accepted PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2010/9/30/medline SP - 737 EP - 41 JF - The American journal of cardiology JO - Am J Cardiol VL - 106 IS - 5 N2 - Atrial fibrillation (AF) and atrial flutter (AFL) after heart transplantation (HT) has been associated with increased mortality. Diverse incidence rates have been reported to date, with no clear classification according to the time of onset of such arrhythmias. We determined the incidence of AF/AFL using the time of onset after HT and analyzed the associated risk factors and outcomes. We performed a retrospective study of 228 HT recipients (March 1996 to July 2007), including donor and recipient demographics, gender mismatch, ischemia time, surgical anastomosis, time of onset of AF/AFL, acute cellular rejection, left ventricular systolic function, and all-cause mortality. The mean age of the donors (81% men) was 30 +/- 12 years and of the recipients (78% men) was 53 +/- 11 years. AF/AFL occurred in 45 patients (20%): 24 (11%) in the first 30 days, 10 (4%) within the 31 days to 1 year, and 11 (5%) after 1 year. When the patients with AF/AFL were compared to those with sinus rhythm, the significant difference was the older mean age of the donors (p = 0.001) and the recipients (p = 0.02). The all-cause mortality rate was 43% for those with AF/AFL compared to 23% for those with sinus rhythm (hazard ratio 2.45; 95% confidence interval 1.2 to 4.8), mostly driven by the greater mortality in the later-onset AF/AFL group (>30 days after HT). In conclusion, AF and AFL have an incidence of 20% after HT and are associated with increased overall mortality compared to that in patients in sinus rhythm. AF/AFL is more common within the first 30 days of HT, with an overall incidence of 20%. Older donor and recipient age is a risk factor associated with AF/AFL. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20723655/Incidence_risk_factors_and_clinical_outcomes_of_atrial_fibrillation_and_atrial_flutter_after_heart_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)00971-9 DB - PRIME DP - Unbound Medicine ER -