Late sinus and atrial tachycardia after pediatric heart transplantation might predict poor outcome

R. Peter Vande Kappelle, Katheryn Gambetta, Barbara J. Deal, Carl L. Backer, Christine L. Sullivan, Elfriede Pahl

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Our objective was to examine clinical/electrocardiogram (ECG) predictors and outcomes of arrhythmias beyond 1 year after pediatric heart transplantation (HTx). We performed a retrospective chart review of 94 1-year HTx survivors, 1988-2006. Clinical records identified patients with arrhythmias occurring >1 year after HTx requiring pharmacotherapy, excluding acute rejection. We reviewed preoperative diagnosis, gender, age at HTx, operative details, transplant coronary artery disease (TCAD), and mortality. We analyzed serial ECGs after HTx for HR, PR, QRS, QT, and QTc intervals. Our results found complete data in 58 patients, 14 (24%) with arrhythmia and 44 controls. Arrhythmias occurred 1.1-17.9 years after HTx (mean = 6.8): 11 focal atrial tachycardia, 1 atrial fibrillation/flutter, 1 atrioventricular node reentry tachycardia; only 1 patient had ventricular tachycardia (VT). Serial ECG intervals were similar between groups, as well as surgical technique, ischemic time, and rejection history. Seven patients (50%) with arrhythmias had death or graft death versus 11% of the controls (P = 0.006). Patients with arrhythmias were more likely to be diagnosed with TCAD (P = 0.007). The patient with VT had no TCAD. In conclusion, supraventricular arrhythmias were frequent (22%) in 1-year survivors of pediatric HTx. These patients were more likely to develop TCAD and/or graft loss/mortality.

Original languageEnglish (US)
Pages (from-to)643-649
Number of pages7
JournalPediatric Cardiology
Volume31
Issue number5
DOIs
StatePublished - Jul 1 2010

Fingerprint

Sinus Tachycardia
Heart Transplantation
Cardiac Arrhythmias
Pediatrics
Transplants
Coronary Artery Disease
Electrocardiography
Ventricular Tachycardia
Tachycardia
Survivors
Atrioventricular Node
Atrial Flutter
Mortality
Atrial Fibrillation
History
Drug Therapy

Keywords

  • Arrhythmia
  • Heart transplant
  • Pediatric
  • Tachycardia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

@article{56073ab200a14b2481ca3798ca875c9d,
title = "Late sinus and atrial tachycardia after pediatric heart transplantation might predict poor outcome",
abstract = "Our objective was to examine clinical/electrocardiogram (ECG) predictors and outcomes of arrhythmias beyond 1 year after pediatric heart transplantation (HTx). We performed a retrospective chart review of 94 1-year HTx survivors, 1988-2006. Clinical records identified patients with arrhythmias occurring >1 year after HTx requiring pharmacotherapy, excluding acute rejection. We reviewed preoperative diagnosis, gender, age at HTx, operative details, transplant coronary artery disease (TCAD), and mortality. We analyzed serial ECGs after HTx for HR, PR, QRS, QT, and QTc intervals. Our results found complete data in 58 patients, 14 (24{\%}) with arrhythmia and 44 controls. Arrhythmias occurred 1.1-17.9 years after HTx (mean = 6.8): 11 focal atrial tachycardia, 1 atrial fibrillation/flutter, 1 atrioventricular node reentry tachycardia; only 1 patient had ventricular tachycardia (VT). Serial ECG intervals were similar between groups, as well as surgical technique, ischemic time, and rejection history. Seven patients (50{\%}) with arrhythmias had death or graft death versus 11{\%} of the controls (P = 0.006). Patients with arrhythmias were more likely to be diagnosed with TCAD (P = 0.007). The patient with VT had no TCAD. In conclusion, supraventricular arrhythmias were frequent (22{\%}) in 1-year survivors of pediatric HTx. These patients were more likely to develop TCAD and/or graft loss/mortality.",
keywords = "Arrhythmia, Heart transplant, Pediatric, Tachycardia",
author = "Kappelle, {R. Peter Vande} and Katheryn Gambetta and Deal, {Barbara J.} and Backer, {Carl L.} and Sullivan, {Christine L.} and Elfriede Pahl",
year = "2010",
month = "7",
day = "1",
doi = "10.1007/s00246-010-9662-4",
language = "English (US)",
volume = "31",
pages = "643--649",
journal = "Pediatric Cardiology",
issn = "0172-0643",
publisher = "Springer New York",
number = "5",

}

Late sinus and atrial tachycardia after pediatric heart transplantation might predict poor outcome. / Kappelle, R. Peter Vande; Gambetta, Katheryn; Deal, Barbara J.; Backer, Carl L.; Sullivan, Christine L.; Pahl, Elfriede.

In: Pediatric Cardiology, Vol. 31, No. 5, 01.07.2010, p. 643-649.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Late sinus and atrial tachycardia after pediatric heart transplantation might predict poor outcome

AU - Kappelle, R. Peter Vande

AU - Gambetta, Katheryn

AU - Deal, Barbara J.

AU - Backer, Carl L.

AU - Sullivan, Christine L.

AU - Pahl, Elfriede

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Our objective was to examine clinical/electrocardiogram (ECG) predictors and outcomes of arrhythmias beyond 1 year after pediatric heart transplantation (HTx). We performed a retrospective chart review of 94 1-year HTx survivors, 1988-2006. Clinical records identified patients with arrhythmias occurring >1 year after HTx requiring pharmacotherapy, excluding acute rejection. We reviewed preoperative diagnosis, gender, age at HTx, operative details, transplant coronary artery disease (TCAD), and mortality. We analyzed serial ECGs after HTx for HR, PR, QRS, QT, and QTc intervals. Our results found complete data in 58 patients, 14 (24%) with arrhythmia and 44 controls. Arrhythmias occurred 1.1-17.9 years after HTx (mean = 6.8): 11 focal atrial tachycardia, 1 atrial fibrillation/flutter, 1 atrioventricular node reentry tachycardia; only 1 patient had ventricular tachycardia (VT). Serial ECG intervals were similar between groups, as well as surgical technique, ischemic time, and rejection history. Seven patients (50%) with arrhythmias had death or graft death versus 11% of the controls (P = 0.006). Patients with arrhythmias were more likely to be diagnosed with TCAD (P = 0.007). The patient with VT had no TCAD. In conclusion, supraventricular arrhythmias were frequent (22%) in 1-year survivors of pediatric HTx. These patients were more likely to develop TCAD and/or graft loss/mortality.

AB - Our objective was to examine clinical/electrocardiogram (ECG) predictors and outcomes of arrhythmias beyond 1 year after pediatric heart transplantation (HTx). We performed a retrospective chart review of 94 1-year HTx survivors, 1988-2006. Clinical records identified patients with arrhythmias occurring >1 year after HTx requiring pharmacotherapy, excluding acute rejection. We reviewed preoperative diagnosis, gender, age at HTx, operative details, transplant coronary artery disease (TCAD), and mortality. We analyzed serial ECGs after HTx for HR, PR, QRS, QT, and QTc intervals. Our results found complete data in 58 patients, 14 (24%) with arrhythmia and 44 controls. Arrhythmias occurred 1.1-17.9 years after HTx (mean = 6.8): 11 focal atrial tachycardia, 1 atrial fibrillation/flutter, 1 atrioventricular node reentry tachycardia; only 1 patient had ventricular tachycardia (VT). Serial ECG intervals were similar between groups, as well as surgical technique, ischemic time, and rejection history. Seven patients (50%) with arrhythmias had death or graft death versus 11% of the controls (P = 0.006). Patients with arrhythmias were more likely to be diagnosed with TCAD (P = 0.007). The patient with VT had no TCAD. In conclusion, supraventricular arrhythmias were frequent (22%) in 1-year survivors of pediatric HTx. These patients were more likely to develop TCAD and/or graft loss/mortality.

KW - Arrhythmia

KW - Heart transplant

KW - Pediatric

KW - Tachycardia

UR - http://www.scopus.com/inward/record.url?scp=77955096100&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955096100&partnerID=8YFLogxK

U2 - 10.1007/s00246-010-9662-4

DO - 10.1007/s00246-010-9662-4

M3 - Article

C2 - 20165843

AN - SCOPUS:77955096100

VL - 31

SP - 643

EP - 649

JO - Pediatric Cardiology

JF - Pediatric Cardiology

SN - 0172-0643

IS - 5

ER -