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Atrial arrhythmias common after lung transplantation
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Onset of atrial arrhythmia is common after lung transplantation, occurring approximately 30% of the time in one cohort, and confers increased mortality risk, researchers reported.
Investigators conducted a retrospective analysis of prospectively collected data on 652 patients (median age, 61 years; 58% men) who underwent lung transplantation between 2008 and October 2013. Patients were stratified based on whether they had an atrial arrhythmia after the procedure.
The researchers compared characteristics of those who developed atrial arrhythmia vs. those who did not and identified factors associated with onset of atrial arrhythmia. Patients were followed until occurrence of one of three outcomes: onset of in-hospital atrial arrhythmia, in-hospital death before onset of atrial arrhythmia or discharge before onset of atrial arrhythmia.
“We observed a high frequency of this relationship: Thirty percent of patients with lung transplantation got an atrial arrhythmia,” Jonathan D’Cunha, MD, PhD, FACS, associate professor in the department of cardiothoracic surgery and chief of lung transplantation at the University of Pittsburgh Medical Center, told Cardiology Today. “The onset most often occurred in the first week, in particular, right around day 5. That is of meaningful importance to us.”
Jonathan D’Cunha
Among the study population, 198 (30.4%) patients had in-hospital atrial arrhythmia before death or discharge, occurring a median of 5 days after transplantation.
D’Cunha and colleagues determined that independent risk factors for atrial arrhythmia after lung transplantation were age (HR per additional year = 1.03; P < .001) and prior CABG (HR = 2.77; P = .002).
The 11.7% of patients with a history of atrial arrhythmia were less likely than those with no history to develop atrial arrhythmia after transplantation (14.5% vs. 32.5%; P < .001), according to the researchers.
After adjustment for other risk factors, atrial arrhythmia after transplantation predicted long-term mortality (HR = 1.63; P = .007), D’Cunha and colleagues wrote.
“Atrial arrhythmia is linked to long-term survival, so we must formulate management strategies that are effective and minimize any potential downstream side effects,” D’Cunha told Cardiology Today. – by Erik Swain
For more information:
Jonathan D’Cunha, MD, PhD, can be reached at Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop St., Suite C900, Pittsburgh, PA 15213; email: dcunhaj@upmc.edu.
Disclosure: D’Cunha reports no relevant financial disclosures. One researcher reports holding equity in Intuitive Surgical.
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