Abstract 9666: Prevalence, Risk Factors and Impact on Mortality of Postoperative Atrial Arrhythmia in Lung Transplant Recipients
Introduction: The aim of this study was to examine prevalence, risk factors and impact on mortality of new-onset atrial arrhythmia (AA) after isolated lung transplantation.
Hypothesis: Occurence of postoperative AA is associated with lower survival after lung transplantation.
Methods: This is a retrospective observational study of consecutive isolated lung transplant recipients. AA was defined as atrial fibrillation or atrial flutter. A total of 324 cases were identified. Patients with known history of AA were excluded (n=31). Logistic regression and Kaplan Meier analysis were utilized to evaluate potential risk factors and impact of AA on mortality.
Results: The final cohort comprised of 293 cases. Mean age was 57 ±13 years. Primary lung pathologies were Obstructive diseases (26%; 77/293), Vascular diseases (2%; 6/293), Cystic fibrosis (7%; 21/293) and Restrictive diseases (65%; 189/293). Prevalence of AA post transplantation was 31 %(90/293) with a bimodal distribution of onset. The highest prevalence occurred in immediate post-transplant period (early AA) accounting for 25 %( 73/293) of all patients and followed by the smaller peak after 1 year post transplant (5%; 16/293) as shown in fig 1A. In multivariable analysis, occurrence of early AA was independently associated with double lung transplantation (HR 2.847 vs single lung; 95%CI1.402-5.777; p=0.004), mean pulmonary artery pressure (HR 0.950; 95%CI0.911-0.991; p=0.018) and age (HR 1.039; 95%CI1.007-1.072; p=0.017). Patients with early AA had lower survival compared to those without early AA (40 months; 95%CI 34-45 months VS 51 months; 95% CI 48-54 months; p=0.040; log-rank test)as shown in fig 1B.
Conclusions: Our study demonstrated high prevalence of early AA after lung transplantation with its bimodal distribution of onset. Age, mean pulmonary artery pressure and double lung transplant were potential predictors. Early AA was associated with higher all-cause mortality.
Author Disclosures: K. Chaikriangkrai: None. S. Jyothula: None. H. Jhun: None. S. Chang: None. M. Valderrabano: None.
- © 2014 by American Heart Association, Inc.