Abstract 15583: Incidence, Risk Factors and Clinical Impact of Atrial Arrhythmias After Lung Transplantation

Introduction: Atrial arrhythmias (AAs) after lung transplantation (LT) are common but, clinical implications of postoperative AA are not fully determined. We aimed to investigate the incidence, risk factors and clinical outcomes of AAs after LT in adults. Methods: Total 90 consecutive patients who underwent LT from 2012 to 2015 were evaluated retrospectively. An arrhythmia episode is defined as documented atrial fibrillation (AF), atrial flutter (AFL) or atrial tachycardia (AT) lasting > 30 minutes on 12-lead ECG or telemetry monitoring. Results: Postoperative AAs occurred in 30 of 90 patients, of whom 21 patients had AF, 16 had AFL, and 9 had AT. The mean time to onset after LT was 8.8 ± 8.1 days for AF, 12.4 ± 8.2 days for AFL and 27.3 ± 27.2 days for AT, respectively. AAs were more likely to occur in patients with older age (56.7 ± 11.4 AAs vs. no AAs group 49.1 ± 14.6; p=0.008), combined coronary artery disease (16.7% vs. 3.3%; p=0.039), history of AF before LT (13.3% vs. 1.7%; p=0.041) and postoperative tracheostomy (73.3% vs. 40%; p=0.003) which means longer period of mechanical ventilation. Advanced age (hazard ratio [HR] 1.04, p=0.048) and postoperative tracheostomy (HR 4.02, p=0.007) were found to be independent factors for AAs after surgery. Although most of AAs were paroxysmal, and well controlled with rate control strategy, in-hospital mortality (43.3% vs. 15%; p=0.003) and 1 year overall mortality (60% vs. 26.7%; p=0.002) were higher in patients with postoperative AAs. Conclusions: Incidence of AAs after LT was 33.3% in this study. Advanced age and postoperative tracheostomy, which indicates longer duration of mechanical ventilation increase the risk of AAs after LT. AAs were relatively transient after LT, but significantly related with increased mortality. Figure 1. Kaplan-Meier curve showing 1 year survival in lung transplant patients