title: Supraventricular tachyarrhythmias after hematopoietic stem cell transplantation: incidence, risk factors and outcomes.
abstract: Recent studies suggest that cancer patients may be at increased risk for supraventricular tachyarrhythmias (SVTA). We have observed clinically significant SVTA in patients undergoing hematopoietic stem cell transplantation occurring at a median of 6 days post transplant, manifesting as atrial fibrillation/flutter or regular narrow-complex tachycardia and persisting for a median of 3 days (range, 0-8). All patients received aggressive medical therapy and/or electrical cardioversion to restore sinus rhythm and to re-establish hemodynamic stability. Non-Hodgkin's lymphoma (NHL) was the most common diagnosis (53%), and a case control analysis in those patients demonstrated that SVTA occurred in 12% of patients and was associated with older age and pre-existing cardiac conditions. In conclusion, patients undergoing HSCT are at moderate risk for developing SVTA, particularly older patients with a diagnosis of NHL. These arrhythmias are clinically significant, and are a marker for increased mortality and prolonged hospital stay. Additional studies are needed to identify high-risk patients who may benefit from prophylactic anti-arrhythmic therapy.
authors.affiliation: Division of Oncology, Section of BMT and Leukemia, and Division of Cardiology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Hidalgo
authors.forename: R
authors.initials: R
authors.lastname: Krone
authors.forename: M W
authors.initials: MW
authors.lastname: Rich
authors.forename: K
authors.initials: K
authors.lastname: Blum
authors.forename: D
authors.initials: D
authors.lastname: Adkins
authors.forename: M-Y
authors.initials: MY
authors.lastname: Fan
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.forename: S
authors.initials: S
authors.lastname: Devine
authors.forename: T
authors.initials: T
authors.lastname: Graubert
authors.forename: W
authors.initials: W
authors.lastname: Blum
authors.forename: M
authors.initials: M
authors.lastname: Tomasson
authors.forename: L T
authors.initials: LT
authors.lastname: Goodnough
authors.forename: R
authors.initials: R
authors.lastname: Vij
authors.forename: J
authors.initials: J
authors.lastname: DiPersio
authors.forename: H
authors.initials: H
authors.lastname: Khoury
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000401:mortality*; D016896:Treatment Outcome