title: Early and Late Atrial Arrhythmias After Lung Transplantation　- Incidence, Predictive Factors and Impact on Mortality.
abstract: Atrial arrhythmias (AAs) are frequent after lung transplantation (LT) and late postoperatively. Several predictive factors of early postoperative AAs after LT have been identified but those of late AAs remain unknown. Whether AA after LT affects mortality is still being debated. This study assessed in a large cohort of LT patients the incidence of AAs early and late after surgery, their predictive factors and their effect on mortality.
  
  
  
  We studied 271 consecutive LT patients over 9 years. Mean follow-up was 2.9±2.4 years. 33% patients developed postoperative AAs. Age (odds ratio (OR) 2.35; confidence interval (CI) [1.31-4.24]; P=0.004) and chronic obstructive pulmonary disease (OR 2.13; CI [1.12-4.03]; P=0.02) were independent predictive factors of early AAs. Late AAs occurred 2.2±2.7 years after transplant in 8.8% of the patients. Pretransplant systolic pulmonary arterial pressure (PTsPAP) was the only independent predictive factor of late AA (OR 1.028; CI [1.001-1.056]; P=0.04). Double LT was associated with long-term freedom from atrial fibrillation (AF) but not from atrial flutter (AFL). Early and late AAs after surgery had no effect on mortality. Double LT was associated with better survival.
  
  
  
  Early AA following LT is common in contrast with the low occurrence of late, often organized, AA. Early and late AAs do not affect mortality. PTsPAP is an independent predictor of late AA. Double LT protects against late AF but not AFL.
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Barraud
authors.affiliation: Department of Cardiology, Austin and Northern Health.
authors.forename: Han S
authors.initials: HS
authors.lastname: Lim
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Halim
authors.initials: H
authors.lastname: Marzak
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Nathan
authors.initials: N
authors.lastname: Messas
authors.affiliation: Department of Pneumology, University Hospital of Strasbourg.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Hirschi
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg.
authors.forename: Nicola
authors.initials: N
authors.lastname: Santelmo
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg.
authors.forename: Anne
authors.initials: A
authors.lastname: Olland
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg.
authors.forename: Pierre Emmanuel
authors.initials: PE
authors.lastname: Falcoz
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Massard
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Michel
authors.initials: M
authors.lastname: Kindo
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Michel
authors.initials: M
authors.lastname: Chauvin
authors.affiliation: Department of Cardiology, University Hospital of Strasbourg.
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.affiliation: Department of Pneumology, University Hospital of Strasbourg.
authors.forename: Romain
authors.initials: R
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000401:mortality; D001281:Atrial Fibrillation; D001282:Atrial Flutter; D002648:Child; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008875:Middle Aged; D009026:Mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors
keywords: Atrial fibrillation; Atrial flutter; Catheter ablation; Lung transplantation; Mortality