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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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Hauptverfasser: Rahm, Ann-Kathrin (VerfasserIn) , Reinhardt, Susanne (VerfasserIn) , Helmschrott, Matthias (VerfasserIn) , Darche, Fabrice Fernand (VerfasserIn) , Bruckner, Thomas (VerfasserIn) , Lugenbiel, Patrick (VerfasserIn) , Thomas, Dierk (VerfasserIn) , Ehlermann, Philipp (VerfasserIn) , Sommer, Wiebke (VerfasserIn) , Warnecke, Gregor (VerfasserIn) , Frey, Norbert (VerfasserIn) , Rivinius, Rasmus (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 3 October 2022
In: Journal of cardiovascular development and disease
Year: 2022, Jahrgang: 9, Heft: 10, Pages: 1-17
ISSN:2308-3425
DOI:10.3390/jcdd9100337
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcdd9100337
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2308-3425/9/10/337
Volltext
Verfasserangaben:Ann-Kathrin Rahm, Susanne Reinhardt, Matthias Helmschrott, Fabrice F. Darche, Tom Bruckner, Patrick Lugenbiel, Dierk Thomas, Philipp Ehlermann, Wiebke Sommer, Gregor Warnecke, Norbert Frey and Rasmus Rivinius
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 04.01.2023
Beschreibung:Online Resource
ISSN:2308-3425
DOI:10.3390/jcdd9100337

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