Document Detail


Incidence, risk factors, and clinical outcomes of atrial fibrillation and atrial flutter after heart transplantation.
MedLine Citation:
PMID:  20723655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Tarun W Dasari; Biljana Pavlovic-Surjancev; Nilamkumar Patel; Alexis A Williams; Phoebe Ezidinma; Arti Rupani; James L Sinacore; Alain L Heroux
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Publication Detail:
Type:  Journal Article     Date:  2010-07-23
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  737-41     Citation Subset:  AIM; IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
Loyola University Medical Center, Maywood, Illinois, USA. dasaritarun@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Atrial Fibrillation / diagnosis,  epidemiology*,  therapy
Atrial Flutter / diagnosis,  epidemiology*,  therapy
Cardiomyopathies / mortality,  physiopathology,  surgery*
Cohort Studies
Female
Heart Transplantation / adverse effects*
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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