Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality
Abstract Aims Atrial fibrillation (AF) after heart transplantation (HTX) is associated with worse clinical outcomes. The current study aimed to analyse the association between AF before HTX and AF within 30 days after HTX. Methods and results This study included 639 adults who received HTX at Heidel...
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doaj-bb11f8ff2aa04332ac88b5d9719d29f52021-10-08T11:50:38ZengWileyESC Heart Failure2055-58222021-10-01854265427710.1002/ehf2.13552Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortalityFabrice F. Darche0Matthias Helmschrott1Ann‐Kathrin Rahm2Dierk Thomas3Patrick A. Schweizer4Tom Bruckner5Philipp Ehlermann6Michael M. Kreusser7Gregor Warnecke8Norbert Frey9Rasmus Rivinius10Department of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyInstitute for Medical Biometry and Informatics University of Heidelberg Heidelberg GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiac Surgery Heidelberg University Hospital Heidelberg GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyDepartment of Cardiology, Angiology and Pneumology Heidelberg University Hospital Im Neuenheimer Feld 410 Heidelberg 69120 GermanyAbstract Aims Atrial fibrillation (AF) after heart transplantation (HTX) is associated with worse clinical outcomes. The current study aimed to analyse the association between AF before HTX and AF within 30 days after HTX. Methods and results This study included 639 adults who received HTX at Heidelberg Heart Center. Patients were subdivided into four groups depending on the status of AF before and after HTX. Analyses comprised recipient and donor data, medication, echocardiographic features, permanent pacemaker implantation, stroke, and mortality after HTX. Three hundred thirty‐two patients (52.0%) had neither AF before nor after HTX, 15 patients (2.3%) had no AF before HTX but showed AF after HTX, 219 patients (34.3%) showed AF before HTX but had no AF after HTX, and 73 patients (11.4%) had AF before and after HTX. Patients with AF before and after HTX had a higher 1 year post‐transplant mortality (39.7%) than patients without AF before or after HTX (18.1%, P < 0.01). Secondary outcomes showed a higher percentage of enlarged atria, ventricular dysfunction, mitral regurgitation, 1‐year stroke, and 1‐year permanent pacemaker implantation in patients with AF before and after HTX. Multivariate analysis revealed a six‐fold elevated risk for post‐transplant AF in patients with AF before HTX (hazard ratio: 6.59, confidence interval: 3.72–11.65; P < 0.01). Further risk factors for post‐transplant AF were higher donor age and prolonged ischaemic time, whereas total orthotopic HTX was associated with a two‐fold lower risk for post‐transplant AF. Conclusions Atrial fibrillation before HTX is a risk factor for post‐transplant AF, permanent pacemaker implantation, and mortality after HTX.https://doi.org/10.1002/ehf2.13552Atrial fibrillationHeart transplantationPacemakerStrokeSurvival |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fabrice F. Darche Matthias Helmschrott Ann‐Kathrin Rahm Dierk Thomas Patrick A. Schweizer Tom Bruckner Philipp Ehlermann Michael M. Kreusser Gregor Warnecke Norbert Frey Rasmus Rivinius |
spellingShingle |
Fabrice F. Darche Matthias Helmschrott Ann‐Kathrin Rahm Dierk Thomas Patrick A. Schweizer Tom Bruckner Philipp Ehlermann Michael M. Kreusser Gregor Warnecke Norbert Frey Rasmus Rivinius Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality ESC Heart Failure Atrial fibrillation Heart transplantation Pacemaker Stroke Survival |
author_facet |
Fabrice F. Darche Matthias Helmschrott Ann‐Kathrin Rahm Dierk Thomas Patrick A. Schweizer Tom Bruckner Philipp Ehlermann Michael M. Kreusser Gregor Warnecke Norbert Frey Rasmus Rivinius |
author_sort |
Fabrice F. Darche |
title |
Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
title_short |
Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
title_full |
Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
title_fullStr |
Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
title_full_unstemmed |
Atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
title_sort |
atrial fibrillation before heart transplantation is a risk factor for post‐transplant atrial fibrillation and mortality |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2021-10-01 |
description |
Abstract Aims Atrial fibrillation (AF) after heart transplantation (HTX) is associated with worse clinical outcomes. The current study aimed to analyse the association between AF before HTX and AF within 30 days after HTX. Methods and results This study included 639 adults who received HTX at Heidelberg Heart Center. Patients were subdivided into four groups depending on the status of AF before and after HTX. Analyses comprised recipient and donor data, medication, echocardiographic features, permanent pacemaker implantation, stroke, and mortality after HTX. Three hundred thirty‐two patients (52.0%) had neither AF before nor after HTX, 15 patients (2.3%) had no AF before HTX but showed AF after HTX, 219 patients (34.3%) showed AF before HTX but had no AF after HTX, and 73 patients (11.4%) had AF before and after HTX. Patients with AF before and after HTX had a higher 1 year post‐transplant mortality (39.7%) than patients without AF before or after HTX (18.1%, P < 0.01). Secondary outcomes showed a higher percentage of enlarged atria, ventricular dysfunction, mitral regurgitation, 1‐year stroke, and 1‐year permanent pacemaker implantation in patients with AF before and after HTX. Multivariate analysis revealed a six‐fold elevated risk for post‐transplant AF in patients with AF before HTX (hazard ratio: 6.59, confidence interval: 3.72–11.65; P < 0.01). Further risk factors for post‐transplant AF were higher donor age and prolonged ischaemic time, whereas total orthotopic HTX was associated with a two‐fold lower risk for post‐transplant AF. Conclusions Atrial fibrillation before HTX is a risk factor for post‐transplant AF, permanent pacemaker implantation, and mortality after HTX. |
topic |
Atrial fibrillation Heart transplantation Pacemaker Stroke Survival |
url |
https://doi.org/10.1002/ehf2.13552 |
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