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A retrospective evaluation of catheter ablation in atrial flutter post cardiac transplantation

Lookup NU author(s): Dr Adam McDiarmid, Dr Iain Matthews, Jayant Kakarla, Dr Janet McComb, Dr Gareth Parry

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Abstract

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Background: Atrial flutter is the most common arrhythmia post cardiac transplantation. Observational studies in the non-transplant population have shown prognostic benefit with catheter ablation; however, there are no data in the heart transplant population. Objectives: This study evaluated the experience of catheter ablation in atrial flutter post cardiac transplantation. Methods: A retrospective review of experience of late onset atrial flutter at the Freeman Hospital, Newcastle-upon-Tyne, UK, between 1985 and January 2020. Results: Sixty eight of the 722 patients who survived 6 months post cardiac transplantation developed late atrial flutter giving an incidence of 9.4%. Thirty-two patients were managed with ablation with treatment largely determined by time of flutter onset. Kaplan Meier estimates for arrhythmia free survival post first ablation for organized atrial arrhythmias was 83.3% at 1 year. Kaplan-Meier estimates for median survival post onset of atrial arrhythmias treated with ablation was 11.34 years (95% CI 8.00–14.57), compared to 5.79 years in patients managed medically (95%CI 2.26–9.32) (P =.026). Conclusions: Atrial flutter is an important late complication of cardiac transplantation. Patients treated with ablation in the modern era had increased survival compared to a historical cohort.


Publication metadata

Author(s): Taylor ME, McDiarmid AK, Matthews IG, Kakarla J, McComb JM, Parry G, Lord SW

Publication type: Article

Publication status: Published

Journal: Clinical Transplantation

Year: 2021

Pages: Epub ahead of print

Online publication date: 15/07/2021

Acceptance date: 12/07/2021

ISSN (print): 0902-0063

ISSN (electronic): 1399-0012

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/ctr.14429

DOI: 10.1111/ctr.14429


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