The influence of surgical technique on early posttransplant atrial fibrillation &amp;mdash; comparison of biatrial, bicaval, and total orthotopic heart transplantation

Rivinius, Rasmus; Helmschrott, Matthias; Ruhparwar, Arjang; Erbel, Christian; Gleissner, Christian A.; Darche, Fabrice F.; Thomas, Dierk; Bruckner, Tom; Katus, Hugo A.; Doesch, Andreas O.

doi:10.2147/tcrm.s126869

Cited by 24 publications

(146 citation statements)

References 23 publications

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“…Data were taken from the clinical routine and analyzed in pseudonymized form. As only clinical routine data were used for this study, no additional written informed consent was required from the patients 9,17,18…”

Section: Methodsmentioning

confidence: 99%

“…We performed 12-lead electrocardiography (ECG) regularly and in case of any suspected arrhythmic disorder. Before discharge, 24-hour-holter-recording was performed 9,17,18…”

Section: Methodsmentioning

confidence: 99%

“…Follow-up appointments included taking of medical history, physical examination, ECG, and laboratory analysis including monitoring of immunosuppressive drug level. Moreover, endomyocardial biopsy and echocardiography were routinely done 9,17–20…”

Section: Methodsmentioning

confidence: 99%

“…The immunosuppressive drug regimen consisting of azathioprine (AZA) and cyclosporine A (CsA) was consecutively substituted by mycophenolate mofetil (MMF) and CsA from 2001 onwards, and by MMF and tacrolimus (TAC) from 2006 onwards. Concurrently, steroids (prednisolone) were given in the initial posttrans-plant period 9,17,18…”

Section: Methodsmentioning

confidence: 99%

“…Log-rank tests (Kaplan–Meier estimator) were applied for analyzing survival after HTX. Statistical significance was defined as a P -value of <0.0500 9,17,18…”

Section: Methodsmentioning

confidence: 99%

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Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Rivinius¹,

Helmschrott²,

Ruhparwar

et al. 2017

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BackgroundMajor concerns about the safety of pretransplant amiodarone use have been raised. As a result of its long half-life, the cardiac allograft is exposed to amiodarone posing potential risks such as bradycardia, requirement for pacemaker implantation, or increased mortality after heart transplantation (HTX).ObjectiveThe aim of this study is to investigate the posttransplant outcomes of patients with no, acute, or chronic amiodarone use before HTX.MethodsThis retrospective single-center study included 530 adult patients who received HTX between 06/1989 and 12/2012. Patients were stratified by their amiodarone therapy before HTX: no continuous amiodarone use (≤90 days before HTX), acute amiodarone use (≤90 days before HTX), and chronic amiodarone use (>90 days before HTX). Differences between the 3 groups in demographics, posttransplant medication, echocardiographic features, heart rates including occurrences of bradycardia, permanent pacemaker implantation, atrial fibrillation (AF), and survival were analyzed.ResultsA total of 412 patients (77.7%) were in the “no amiodarone” group, 23 patients (4.4%) in the “acute amiodarone” group, and 95 patients (17.9%) in the “chronic amiodarone” group. Left ventricular ejection fraction (P=0.5819), heart rates including occurrence of bradycardia during posttransplant week 1 (P=0.0979 and P=0.2695), week 2 (P=0.1214 and P=0.8644), week 3 (P=0.1033 and P=0.8894), and week 4 (P=0.2892 and P=0.8644), permanent pacemaker implantation within 30-day (P=0.8644), or overall follow-up after HTX (P=0.8664) were not significant between groups. Patients with chronic pretransplant amiodarone therapy had the lowest rate of early posttransplant AF (P=0.0065). There was no statistically significant difference between groups in 30-day (P=0.8656), 1-year (P=1.0000), 2-year (P=0.8763), 5-year (P=0.5174), or overall posttransplant follow-up mortality (P=0.1936).ConclusionAdministration of acute or chronic pretransplant amiodarone was not related to an increased occurrence of bradycardia, requirement for permanent pacemaker implantation, or mortality after HTX. Importantly, chronic amiodarone use effectively reduced early AF after HTX, whereas acute amiodarone use showed no such effect.

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Section: Methodsmentioning

confidence: 99%

“…We performed 12-lead electrocardiography (ECG) regularly and in case of any suspected arrhythmic disorder. Before discharge, 24-hour-holter-recording was performed 9,17,18…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Log-rank tests (Kaplan–Meier estimator) were applied for analyzing survival after HTX. Statistical significance was defined as a P -value of <0.0500 9,17,18…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Rivinius¹,

Helmschrott²,

Ruhparwar

et al. 2017

DDDT

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Miscellaneous Adverse Events and Causes of Death

Barten,

Reichenspurner

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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Elevated pre‐transplant pulmonary vascular resistance is associated with early post‐transplant atrial fibrillation and mortality

et al. 2020

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Aims Severely elevated pre‐transplant pulmonary vascular resistance (PVR) has been linked to adverse effects after heart transplantation (HTX). The impact of a moderately increased PVR before HTX on post‐transplant outcomes remains uncertain. The aim of this study was to investigate the effects of an elevated pre‐transplant PVR ≥ 300 dyn·s·cm−5 (≥3.75 Wood units) on outcomes after HTX. Methods and results This observational retrospective single‐centre study included 561 patients receiving HTX at Heidelberg Heart Center between 1989 and 2015. Patients were stratified by degree of pre‐transplant PVR. Analyses covered demographics, post‐transplant medication, mortality and causes of death after HTX, early post‐transplant atrial fibrillation (AF), and length of the initial hospital stay after HTX. Ninety‐four patients (16.8%) had a PVR ≥ 300 dyn·s·cm−5 (≥3.75 Wood units). These patients had a higher rate of early post‐transplant AF [20.2 vs. 10.7%, difference: 9.5%, 95% confidence interval (CI): 0.9–18.1%, P = 0.01] and an increased 30 day post‐transplant mortality (25.5 vs. 6.4%, hazard ratio: 4.4, 95% CI: 2.6–7.6, P < 0.01), along with a higher percentage of death due to transplant failure (21.2 vs. 4.1%, difference: 17.1%, 95% CI: 8.7–25.5%, P < 0.01). Multivariate analysis revealed a PVR ≥ 300 dyn·s·cm−5 (≥3.75 Wood units) as a significant risk factor for increased 30 day mortality after HTX (hazard ratio: 4.4, 95% CI: 2.5–7.6, P < 0.01). Kaplan–Meier estimator showed a lower 2 year survival after HTX (P < 0.01) in patients with a PVR ≥ 300 dyn·s·cm−5 (≥3.75 Wood units). Conclusions Elevated pre‐transplant PVR ≥ 300 dyn·s·cm−5 (≥3.75 Wood units) is associated with early post‐transplant AF and increased mortality after HTX.

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The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation

Cited by 24 publications

References 23 publications

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Comparison of posttransplant outcomes in patients with no, acute, or chronic amiodarone use before heart transplantation

Miscellaneous Adverse Events and Causes of Death

Elevated pre‐transplant pulmonary vascular resistance is associated with early post‐transplant atrial fibrillation and mortality

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