Amiodarone therapy does not compromise subsequent heart transplantation

Chelimsky-Fallick, Catherine; Middlekauff, Holly R.; Stevenson, William G.; Kobashigawa, Jon A.; Saxon, Leslie A.; Moriguchi, J.; Brownfield, Erica; Hamilton, Michèle A.; Drinkwater, Davis C.; Laks, Hillel; Stevenson, Lynne Warner

doi:10.1016/0735-1097(92)90450-2

Cited by 44 publications

(17 citation statements)

References 19 publications

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“…Its main bradycardic effects are mediated through its beta receptor blocking activity. Given that the effects of amiodarone will last several weeks after transplantation (23), our finding that pretransplant amiodarone is associated with bradycardia is plausible, and agrees with several studies which demonstrated that pretransplant amiodarone leads to lower post-transplant heart rates (23)(24)(25)(26). The study by Montero et al (2) looked at the effect of pretransplant amiodarone on pacing requirements after transplantation.…”

Section: Discussionsupporting

confidence: 86%

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Goldstein

Coffey

Benza

et al. 2003

American Journal of Transplantation

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Since the effects of bradycardia after cardiac transplantation are not known, we tested the hypothesis that perioperative bradycardia would lead to an increase in adverse outcomes after cardiac transplantation. We conducted a retrospective case control study with inclusion criterion of a heart rate (HR) less than 80 bpm during the 1st week after transplantation. Control patients were matched for gender, age and time since transplantation. We identified 34 patients as having perioperative bradycardia out of the 174 who underwent cardiac transplantation between 1994 and 1997. The results demonstrated no significant differences in donor ischemic times (180 vs. 183, p = 0.88), operative surgeon (p = 0.62) or pretransplant cardiac disease (p = 0.81) between groups. Bradycardic patients were more likely to be on pretransplant amiodarone (RR = 20.4, p < 0.001). Perioperative bradycardia did not lead to increases in cellular rejection (p = 0.72) or vasculopathy (p = 0.79). The patients prescribed pretransplant amiodarone (n = 14) had a trend toward delayed time to first rejection episode (31.0 vs. 15.5 days, median, p = 0.07).In conclusion, perioperative bradycardia does not increase adverse outcomes after cardiac transplantation and is associated with pretransplant use of amiodarone. Amiodarone may modify the recipients' immune response by delaying the occurrence of rejection.

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Section: Discussionsupporting

confidence: 86%

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Goldstein

Coffey

Benza

et al. 2003

American Journal of Transplantation

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“…In 2 retrospective series of adult HTx recipients, pretransplant amiodarone use was associated with lower heart rates and higher incidence of atrial pacing without an effect on mortality, rejection, or inotropic support. 15,16 This is largely attributed to the long half-life of amiodarone, which can linger for months after its discontinuation. In addition to amiodarone, other antiarrhythmics could have contributed to the increase in PPM implantation.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker implantation in pediatric heart transplant recipients: Predictors, outcomes, and impact on survival

et al. 2015

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“…Romhilt et a14 studied 13 long-term survivors of cardiac transplantation. Three (23%) patients experienced non-sustained paroxysmal supraventricular tachycardia within the first 30 days, five (38%) experienced sinus bradycardia (undefined), and three (23%) subsequently required implantation of a permanent pacing system.…”

Section: Discussionmentioning

confidence: 99%

Atrial arrhythmias and pacing after orthotopic heart transplantation: bicaval versus standard atrial anastomosis.

Grant

Khan

Faragher

et al. 1995

Heart

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(Br HeartJ 1995;74:149-153) Keywords: bicaval atrial anastomosis; atrial arrhythmias; pacing; transplantation The standard surgical technique for implantation of the transplanted heart described by Lower et all involves excision of the recipient heart with division of the atrial septum, leaving cuffs of the right and left atrium and the great vessels to which the suitably trimmed donor heart is sutured. This technique is relatively simple and quick, and provides access to the anastomoses in cases of postoperative bleeding. It has the disadvantage that the atrial anatomy is distorted. Theoretical disadvantages of this distortion are that function of the tricuspid and mitral valves may be affected, as well as the atrial contribution to ventricular filling. Moreover the atrial surgery which involves substantial incision and suturing of the donor anterior right atrial wall has the potential to disturb the sinus node and produce an arrhythmogenic substrate. An alternative technique involving the use of a small left atrial cuff with anastomoses of the donor and recipient cavas has recently been described at this institution.2 We have compared our results using bicaval and standard anastomoses to determine the incidence of postoperative pacing and atrial arrhythmias. Patients and methods SURGICAL TECHNIQUE

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Amiodarone therapy does not compromise subsequent heart transplantation

Abstract: Amiodarone therapy before heart transplantation may contribute to occasional pulmonary complications but does not significantly increase perioperative morbidity or mortality with the regimens used in this retrospective study.

Cited by 44 publications

References 19 publications

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Pacemaker implantation in pediatric heart transplant recipients: Predictors, outcomes, and impact on survival

Atrial arrhythmias and pacing after orthotopic heart transplantation: bicaval versus standard atrial anastomosis.

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