Atrial Tachyarrhythmias After Cardiac Transplantation

Cantillon, Daniel J.

doi:10.1016/j.ccep.2012.05.006

Cited by 5 publications

(13 citation statements)

References 17 publications

(25 reference statements)

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“…Preoperative medical therapy including beta blockers, amiodarone, and statins may play an important role to reduce the risk of postoperative atrial AF . Thus, heart transplant recipients have a lower incidence of postoperative AF compared to those who undergo conventional open‐heart surgeries, which have been reported up to 50%, approximately 5‐fold higher than the overall estimated incidence of AF following heart transplantation in our study.…”

Section: Discussionmentioning

confidence: 55%

“…Atrial fibrillation (AF) is a well‐established postoperative complication, especially in open‐heart surgeries and is associated with long‐term morbidity and mortality . In heart transplant recipients, AF has been shown to be associated with poor clinical outcomes including coronary allograft vasculopathy, graft rejection, and reduced patient survival .…”

Section: Introductionmentioning

confidence: 99%

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Atrial fibrillation following heart transplantation: A systematic review and meta‐analysis of observational studies

Chokesuwattanaskul

Preechawat

O'Corragain

et al. 2018

J Evidence Based Medicine

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Objective: Previous studies have suggested a high incidence of atrial fibrillation (AF) in heart transplant recipients. However, incidence trends of AF in heart transplant recipients remain unclear. The study's aims were (1) to investigate the pooled incidence/incidence trends of AF following heart transplantation and (2) to assess the mortality risk of heart transplant recipients with AF. Methods:A literature search for studies that reported the incidence of AF following heart transplantation was conducted using MEDLINE, EMBASE, and The Cochrane Database from inception through March 2018. Pooled incidence and odds ratios (OR) with 95%CI were calculated using a random-effects model. Results:Eighteen studies (2 cohorts from clinical trials and 16 cohort studies) with 5393 heart transplant recipients were enrolled. The pooled estimated incidence of AF in heart transplant was 10.1% (95%CI: 7.6%-13.2%). Meta-analysis based on the type of anastomotic technique demonstrated a pooled estimated incidence of AF following heart transplantation of 18.7% (95%CI: 10.3%-31.5%) and 11.1% (95%CI: 6.5%-18.4%) by biatrial and bicaval techniques, respectively.There was a significant association between AF following a heart transplant and increased mortality risk with a pooled OR of 2.86 (95%CI: 2.08-3.93). Meta-regression analyses showed no significant correlations between the year of study and incidence of AF (P = 0.47) or mortality risk of AF after heart transplantation (P = 0.99). Conclusions:The overall estimated incidence of AF following heart transplantation is 10.1%.There is a significant association between AF and increased mortality after transplantation. Furthermore, incidence and mortality risk of AF following heart transplant does not seem to decrease over time. K E Y W O R D Satrial fibrillation, cardiac, heart, meta-analysis, transplant, transplantation is almost 90% with a median survival rate over 10 years. [2][3][4]

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation following heart transplantation: A systematic review and meta‐analysis of observational studies

Chokesuwattanaskul

Preechawat

O'Corragain

et al. 2018

J Evidence Based Medicine

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“…28 Incidence of SVAs after OHT ranges from 0.3% to 24% for AF, and 2.8 to 30% for AFL 13 . The most common arrhythmias in the late follow‐up are AFL and AT, mostly due to reentrant mechanisms associated with incision or anastomosis lines, tissue fibrosis, and recipient‐donor electrical recoupling 4,5,13,25,26 . In all cases, the presence of acute cellular rejection or antibody‐mediated rejection and coronary allograft vasculopathy should be ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors reported the same data; the presence of an accessory pathway as ventricular pre‐excitation mechanisms or a reentry nodal AV arrhythmia with dual conduction is less common. Some reports describe focal AT originating in the venous sinus, right or left suture, left appendage, and tricuspid ring 4,13‐15,17 . In isolated cases, the focal ATs originate in the donor atrium and are transmitted to the recipient, having their genesis in the tissue around the fibrosis generated at the level of the suture lines 5,8,12,28‐30 …”

Section: Discussionmentioning

confidence: 99%

“…Heart transplantation and long‐term mechanical circulatory support with ventricular assist devices as destination therapy are the current leading treatment for these patients 1 . The surgical technique used for orthotopic heart transplantation (OHT) might have implications for the development, treatment, and outcome of supraventricular arrhythmias (SVAs) 2‐4 . The anatomical modifications, secondary to the surgical anastomosis, favor the appearance of macro reentries at the donor atrial level, the recipient atrium or atrio‐atrial anastomosis 5‐7 .…”

Section: Introductionmentioning

confidence: 99%

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Radiofrequency ablation of supraventricular arrhythmias after orthotopic heart transplantation: Long‐term follow‐up of a single‐center experience

Renedo

Gonzalez

Giunta

et al. 2020

Clinical Transplantation

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Background Supraventricular arrhythmias (SVAs), commonly managed with radiofrequency ablation (RFA), may occur after orthotopic heart transplantation (OHT). Methods We retrospectively assessed 514 consecutive patients (pts.) undergoing OHT between January 1990 and July 2016 in a single‐center. Patients with SVAs managed with RFA were included. Mechanisms of genesis of SVAs, association with surgical techniques and outcomes, were analyzed. Results Of 514 pts undergoing OHT, 53% (272 pts.) were managed with bicaval (BC) technique and 47% (242 pts.) with biatrial (BA) technique. Mean follow‐up 10 ± 8.4 years. Nine pts. (1.7%) developed SVA requiring RFA. The BC technique was performed in 4 pts., 3 pts. presented cavotricuspid isthmus‐dependent atrial flutter (CTI AFL), and 1 pt. double loop AFL. Five pts. were managed with BA technique, 4 pts. presented CTI AFL, and 1 pt. atrial tachycardia (AT). Mean time between OHT and SVA occurrence was 6.6 ± 5.5 years. The procedure was successful in 89% (8 pts.). Arrhythmia recurrence was seen in 3 pts (37%), all with BA technique. Conclusion Supraventricular arrhythmias in heart transplantation may be associated with the surgical scar. Identifying the mechanism is vital to choose the appropriate treatment with radiofrequency ablation.

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Atrial arrhythmia in a patient after bicaval heart transplantation: Evidence for recipient-to-donor conduction

Hayek

Gardey

Dulac

et al. 2020

HeartRhythm Case Reports

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Atrial Tachyarrhythmias After Cardiac Transplantation

Cited by 5 publications

References 17 publications

Atrial fibrillation following heart transplantation: A systematic review and meta‐analysis of observational studies

Atrial fibrillation following heart transplantation: A systematic review and meta‐analysis of observational studies

Radiofrequency ablation of supraventricular arrhythmias after orthotopic heart transplantation: Long‐term follow‐up of a single‐center experience

Atrial arrhythmia in a patient after bicaval heart transplantation: Evidence for recipient-to-donor conduction

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