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Title: Atrial fibrillation following heart transplantation: A systematic review and meta-analysis of observational studies
Authors: Ronpichai Chokesuwattanaskul
Tarun Bathini
Charat Thongprayoon
Somchai Preechawat
Oisin A. O'Corragain
Pavida Pachariyanon
Patompong Ungprasert
Wisit Cheungpasitporn
Texas Tech University Health Sciences Center at Lubbock
Temple University
King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University
Faculty of Medicine, Siriraj Hospital, Mahidol University
University of Arizona
Mayo Clinic
University of Mississippi Medical Center
Keywords: Medicine
Issue Date: 1-Nov-2018
Citation: Journal of Evidence-Based Medicine. Vol.11, No.4 (2018), 261-271
Abstract: © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd Objective: Previous studies have suggested a high incidence of atrial fibrillation (AF) in heart transplant recipients. However, incidence trends of AF in heart transplant recipients remain unclear. The study's aims were (1) to investigate the pooled incidence/incidence trends of AF following heart transplantation and (2) to assess the mortality risk of heart transplant recipients with AF. Methods: A literature search for studies that reported the incidence of AF following heart transplantation was conducted using MEDLINE, EMBASE, and The Cochrane Database from inception through March 2018. Pooled incidence and odds ratios (OR) with 95%CI were calculated using a random-effects model. Results: Eighteen studies (2 cohorts from clinical trials and 16 cohort studies) with 5393 heart transplant recipients were enrolled. The pooled estimated incidence of AF in heart transplant was 10.1% (95%CI: 7.6%-13.2%). Meta-analysis based on the type of anastomotic technique demonstrated a pooled estimated incidence of AF following heart transplantation of 18.7% (95%CI: 10.3%-31.5%) and 11.1% (95%CI: 6.5%-18.4%) by biatrial and bicaval techniques, respectively. There was a significant association between AF following a heart transplant and increased mortality risk with a pooled OR of 2.86 (95%CI: 2.08-3.93). Meta-regression analyses showed no significant correlations between the year of study and incidence of AF (P = 0.47) or mortality risk of AF after heart transplantation (P = 0.99). Conclusions: The overall estimated incidence of AF following heart transplantation is 10.1%. There is a significant association between AF and increased mortality after transplantation. Furthermore, incidence and mortality risk of AF following heart transplant does not seem to decrease over time.
ISSN: 17565391
Appears in Collections:Scopus 2018

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