| Supraventricular tachycardia after orthotopic cardiac transplantation. | |
MedLine Citation:
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PMID: 18534271 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to define the incidence, mechanisms, and management, including catheter ablation, of supraventricular tachycardia (SVT) in a large series of patients after orthotopic heart transplantation (OHT). BACKGROUND: Supraventricular arrhythmias are frequently encountered after OHT, but their characteristics in this population have not been well established. METHODS: We analyzed the incidence, clinical course, and management of SVTs in a cohort of 729 adult patients who underwent OHT. Furthermore, the mechanisms of arrhythmias among the patients referred for electrophysiological study (EPS) and ablation were also characterized. RESULTS: The most common arrhythmia was atrial flutter, which occurred in 9% of this cohort. Persistent or paroxysmal atrial fibrillation occurred in 7%, the majority (57%) in the perioperative period. Persistent or paroxysmal atrial fibrillation was observed in OHT patients, beyond the post-operative period, only in the presence of rejection or transplant vasculopathy. Other persistent or paroxysmal SVTs were seen in 47 stable OHT patients (7%). Of these, 24 patients (4%) underwent EPS. Accessory and dual atrioventricular nodal pathways in the donor heart caused SVT in 3 patients. Macro-reentrant atrial tachycardia was seen in 7 patients, and isthmus-dependent atrial flutter occurred in 14 patients. CONCLUSIONS: The majority of SVTs in stable OHT patients can be attributed to macro-reentrant tachycardias (flutter and scar reentry). Catheter ablation is effective in management of these SVTs. Atrial fibrillation was never encountered in stable patients in our series, and its occurrence should prompt an evaluation for acute rejection and/or vasculopathy. |
Authors:
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Marmar Vaseghi; Noel G Boyle; Rohit Kedia; Jignesh K Patel; David A Cesario; Isaac Wiener; Jon A Kobashigawa; Kalyanam Shivkumar |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 51 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-06 Completed Date: 2008-07-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2241-9 Citation Subset: AIM; IM |
Affiliation:
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UCLA Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1679, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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etiology Catheter Ablation* Female Heart Rate Heart Transplantation / adverse effects*, methods Humans Incidence Male Middle Aged Retrospective Studies Risk Factors Tachycardia, Supraventricular / etiology*, mortality, physiopathology, therapy Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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R01HL084261/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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