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Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation

Aims: Atrial flutter (AFL) is a common late-onset complication after heart transplantation (HTX) and is associated with worse clinical outcomes. Methods: This study investigated the frequency, risk factors, and outcomes of late-onset post-transplant AFL. We analyzed 639 adult patients undergoing HTX...

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Autores principales: Rahm, Ann-Kathrin, Reinhardt, Susanne, Helmschrott, Matthias, Darche, Fabrice F., Bruckner, Tom, Lugenbiel, Patrick, Thomas, Dierk, Ehlermann, Philipp, Sommer, Wiebke, Warnecke, Gregor, Frey, Norbert, Rivinius, Rasmus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604694/
https://www.ncbi.nlm.nih.gov/pubmed/36286289
http://dx.doi.org/10.3390/jcdd9100337
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author Rahm, Ann-Kathrin
Reinhardt, Susanne
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Lugenbiel, Patrick
Thomas, Dierk
Ehlermann, Philipp
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
author_facet Rahm, Ann-Kathrin
Reinhardt, Susanne
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Lugenbiel, Patrick
Thomas, Dierk
Ehlermann, Philipp
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
author_sort Rahm, Ann-Kathrin
collection PubMed
description Aims: Atrial flutter (AFL) is a common late-onset complication after heart transplantation (HTX) and is associated with worse clinical outcomes. Methods: This study investigated the frequency, risk factors, and outcomes of late-onset post-transplant AFL. We analyzed 639 adult patients undergoing HTX at the Heidelberg Heart Center between 1989 and 2019. Patients were stratified by diagnosis and type of late-onset post-transplant AFL (>90 days after HTX). Results: A total of 55 patients (8.6%) were diagnosed with late-onset post-transplant AFL, 30 had typical AFL (54.5%) and 25 had atypical AFL (45.5%). Patients with AFL were younger at HTX (p = 0.028), received more biatrial anastomosis (p = 0.001), and presented with moderate or severe tricuspid regurgitation (56.4%). Typical AFL was associated with graft rejection (p = 0.016), whereas atypical AFL was associated with coronary artery disease (p = 0.028) and stent implantation (p = 0.042). Patients with atypical AFL showed a higher all-cause 1-year mortality (p = 0.010) along with a higher rate of graft failure after diagnosis of AFL (p = 0.023). Recurrence of AFL was high (83.6%). Patients with catheter ablation after AFL recurrence had a higher 1-year freedom from AFL (p = 0.003). Conclusions: Patients with late-onset post-transplant AFL were younger at HTX, received more biatrial anastomosis, and showed a higher rate of moderate or severe tricuspid regurgitation. Typical AFL was associated with graft rejection, whereas atypical AFL was associated with myocardial ischemia, graft failure, and mortality. Catheter ablation represents a viable option to avoid further episodes of late-onset AFL after HTX.
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spelling pubmed-96046942022-10-27 Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation Rahm, Ann-Kathrin Reinhardt, Susanne Helmschrott, Matthias Darche, Fabrice F. Bruckner, Tom Lugenbiel, Patrick Thomas, Dierk Ehlermann, Philipp Sommer, Wiebke Warnecke, Gregor Frey, Norbert Rivinius, Rasmus J Cardiovasc Dev Dis Article Aims: Atrial flutter (AFL) is a common late-onset complication after heart transplantation (HTX) and is associated with worse clinical outcomes. Methods: This study investigated the frequency, risk factors, and outcomes of late-onset post-transplant AFL. We analyzed 639 adult patients undergoing HTX at the Heidelberg Heart Center between 1989 and 2019. Patients were stratified by diagnosis and type of late-onset post-transplant AFL (>90 days after HTX). Results: A total of 55 patients (8.6%) were diagnosed with late-onset post-transplant AFL, 30 had typical AFL (54.5%) and 25 had atypical AFL (45.5%). Patients with AFL were younger at HTX (p = 0.028), received more biatrial anastomosis (p = 0.001), and presented with moderate or severe tricuspid regurgitation (56.4%). Typical AFL was associated with graft rejection (p = 0.016), whereas atypical AFL was associated with coronary artery disease (p = 0.028) and stent implantation (p = 0.042). Patients with atypical AFL showed a higher all-cause 1-year mortality (p = 0.010) along with a higher rate of graft failure after diagnosis of AFL (p = 0.023). Recurrence of AFL was high (83.6%). Patients with catheter ablation after AFL recurrence had a higher 1-year freedom from AFL (p = 0.003). Conclusions: Patients with late-onset post-transplant AFL were younger at HTX, received more biatrial anastomosis, and showed a higher rate of moderate or severe tricuspid regurgitation. Typical AFL was associated with graft rejection, whereas atypical AFL was associated with myocardial ischemia, graft failure, and mortality. Catheter ablation represents a viable option to avoid further episodes of late-onset AFL after HTX. MDPI 2022-10-03 /pmc/articles/PMC9604694/ /pubmed/36286289 http://dx.doi.org/10.3390/jcdd9100337 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rahm, Ann-Kathrin
Reinhardt, Susanne
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Lugenbiel, Patrick
Thomas, Dierk
Ehlermann, Philipp
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title_full Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title_fullStr Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title_full_unstemmed Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title_short Frequency, Risk Factors, and Clinical Outcomes of Late-Onset Atrial Flutter in Patients after Heart Transplantation
title_sort frequency, risk factors, and clinical outcomes of late-onset atrial flutter in patients after heart transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604694/
https://www.ncbi.nlm.nih.gov/pubmed/36286289
http://dx.doi.org/10.3390/jcdd9100337
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