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Arrhythmias after cardiac transplantation
C D Scott1, J H Dark, J M McComb
1Cardiothoracic Center, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
The American Journal of Cardiology
|October 15, 1992
Summary
Frequent atrial premature complexes (APCs) after heart transplant are linked to rejection, while ventricular premature complexes (VPCs) decrease over time. Atrial flutter may signal rejection, warranting biopsy.
Area of Science:
- Cardiology
- Transplantation Medicine
- Electrophysiology
Background:
- The clinical significance of arrhythmias post-heart transplantation remains debated.
- Atrial and ventricular premature complexes (APCs and VPCs) are common but their association with rejection is unclear.
Purpose of the Study:
- To investigate the etiology and clinical significance of sustained arrhythmias and premature complexes after heart transplantation.
- To determine the relationship between APCs, VPCs, atrial flutter, and allograft rejection.
Main Methods:
- Fifty adult heart transplant recipients were monitored using continuous telemetry and ambulatory ECG.
- Monitoring occurred at specified intervals up to 24 weeks post-transplantation.
- Data on allograft rejection and arrhythmias were collected and analyzed.
Main Results:
- Higher APC frequency was observed in patients with early allograft rejection (p=0.04).
- APC frequency decreased significantly over time (p=0.04).
- Atrial flutter was more common in rejectors (p=0.04) and often temporally related to rejection; VPC frequency decreased over time (p<0.001) and was unrelated to rejection.
Conclusions:
- Frequent APCs are associated with allograft rejection post-heart transplantation.
- VPC frequency is primarily determined by time post-transplantation, not rejection.
- Atrial flutter should prompt consideration for endomyocardial biopsy due to its association with rejection.