Abstract 13479: New Heart, Old Arrhythmia: Atrial Arrhythmias After Orthotopic Heart Transplantation
Introduction: Arrhythmias after orthotopic heart transplantation (OHT) are common. However the influence of pre-transplant atrial arrhythmia on post-OHT atrial arrhythmia has not been established. In this study we analyzed the occurrence of post-OHT atrial arrhythmias in patients with prior atrial fibrillation or flutter (afib/flutter).
Methods: In this retrospective single center study, 56 patients who underwent OHT from 2003-14 were enrolled. Patients were stratified based on history of pre-OHT afib/flutter. Baseline demographics, and post-transplant outcomes including atrial arrythmias were recorded. Post-OHT atrial arrhythmias were defined as afib/flutter, atrial tachycardia, multifocal atrial tachycardia, and wandering atrial pacemaker Data was analyzed using student’s t-test and X2 analysis.
Results: The cohort comprised of 20 patients with pre-transplant history of afib/flutter and 36 patients without such diagnosis. There was no statistical difference in age, gender or BMI in patients between the two groups. Our analysis revealed that patients with afib/flutter prior to OHT had significantly more atrial arrhythmias at one year compared to those without afib/flutter (31.6% vs 8.8%, p=0.034), and this difference was maintained at five years follow-up (50% vs 11.1%, p=0.001). Additionally, there was a strong trend toward increased overall mortality in in this group (35% vs 13.9%, p=0.065).
Discussion: Our results suggest a novel finding of a link between pre and post-OHT atrial arrhythmias, particularly in the first year after transplantation. This surprising finding may be related to residual recipient pulmonary vein activity, recipient atrial anastomotic tissue, or patient related factors. Further prospective research is indicated to confirm our findings.
Author Disclosures: B.T. Costello: None. B. Mohamedali: None. E.P. Campos: None. J.E. Sturgess: None. A. Deka: None.
- © 2015 by American Heart Association, Inc.