title: Atrial fibrillation following autologous stem cell transplantation in patients with multiple myeloma: incidence and risk factors.
abstract: OBJECTIVE
  Atrial fibrillation (AF) often develops in patients with multiple myeloma following autologous stem cell transplantation (ASCT), but the exact incidence of, and the risk factors for AF have not been described. In this study, we sought to determine the incidence of AF in patients with multiple myeloma undergoing ASCT.
  
  
  METHODS
  Patients who received ASCT for multiple myeloma between January 2000 and December 2009 were identified using the ICD-9 codes for multiple myeloma and ASCT, and formed the basis of this report.
  
  
  RESULTS
  The study included 278 patients (mean age, 63 ± 9.5 years). A total of 75 (27%) patients developed AF at a mean duration of 14.8 days following ASCT. On multiple regression analysis, baseline renal dysfunction (odds ratio 15.2 [confidence interval 5.08-45.6]), left ventricular systolic dysfunction (9.55 [2.78-32.79]), dilated left atrium on echocardiogram (4.97 [1.8-13.78]), and hypertension (3.6 [1.36-9.52]) were significantly associated with the development of AF after ASCT. The presence of light-chain secretion (0.21 [0.07-0.6]) was associated with a lower incidence of AF. Age, gender, and race were not significantly associated with the development of AF after ASCT.
  
  
  CONCLUSIONS
  AF is very frequent in patients with multiple myeloma when they receive ASCT. The presence of abnormal renal function, left ventricular systolic dysfunction, dilated left atrium, or hypertension at baseline identifies patients at high risk of developing AF following ASCT.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #532, Little Rock, AR 72211, USA. rksureddi@gmail.com
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Sureddi
authors.forename: Fariba
authors.initials: F
authors.lastname: Amani
authors.forename: Prabhat
authors.initials: P
authors.lastname: Hebbar
authors.forename: David K
authors.initials: DK
authors.lastname: Williams
authors.forename: Marino
authors.initials: M
authors.lastname: Leonardi
authors.forename: Hakan
authors.initials: H
authors.lastname: Paydak
authors.forename: J L
authors.initials: JL
authors.lastname: Mehta
mesh_terms: D000368:Aged; D001131:Arkansas / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology / Q000601:surgery*; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D013599:Systole; D013997:Time Factors; D014182:Transplantation, Autologous; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology