Early and Late Atrial Arrhythmias After Lung Transplantation - Incidence, Predictive Factors and Impact on Mortality.

Fiche publication


Date publication

avril 2017

Journal

Circulation journal : official journal of the Japanese Circulation Society

Auteurs

Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel, Pr OLLAND Anne


Tous les auteurs :
Jesel L, Barraud J, Lim HS, Marzak H, Messas N, Hirschi S, Santelmo N, Olland A, Falcoz PE, Massard G, Kindo M, Ohlmann P, Chauvin M, Morel O, Kessler R

Résumé

Atrial arrhythmias (AAs) are frequent after lung transplantation (LT) and late postoperatively. Several predictive factors of early postoperative AAs after LT have been identified but those of late AAs remain unknown. Whether AA after LT affects mortality is still being debated. This study assessed in a large cohort of LT patients the incidence of AAs early and late after surgery, their predictive factors and their effect on mortality.Methods and Results:We studied 271 consecutive LT patients over 9 years. Mean follow-up was 2.9±2.4 years. 33% patients developed postoperative AAs. Age (odds ratio (OR) 2.35; confidence interval (CI) [1.31-4.24]; P=0.004) and chronic obstructive pulmonary disease (OR 2.13; CI [1.12-4.03]; P=0.02) were independent predictive factors of early AAs. Late AAs occurred 2.2±2.7 years after transplant in 8.8% of the patients. Pretransplant systolic pulmonary arterial pressure (PTsPAP) was the only independent predictive factor of late AA (OR 1.028; CI [1.001-1.056]; P=0.04). Double LT was associated with long-term freedom from atrial fibrillation (AF) but not from atrial flutter (AFL). Early and late AAs after surgery had no effect on mortality. Double LT was associated with better survival.

Mots clés

Atrial fibrillation, Atrial flutter, Catheter ablation, Lung transplantation, Mortality

Référence

Circ J. 2017 04 25;81(5):660-667