Publication: Atrial fibrillation following heart transplantation: A systematic review and meta-analysis of observational studies
Issued Date
2018-11-01
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ISSN
17565391
17565383
17565383
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2-s2.0-85056665324
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Evidence-Based Medicine. Vol.11, No.4 (2018), 261-271
Suggested Citation
Ronpichai Chokesuwattanaskul, Tarun Bathini, Charat Thongprayoon, Somchai Preechawat, Oisin A. O'Corragain, Pavida Pachariyanon, Patompong Ungprasert, Wisit Cheungpasitporn Atrial fibrillation following heart transplantation: A systematic review and meta-analysis of observational studies. Journal of Evidence-Based Medicine. Vol.11, No.4 (2018), 261-271. doi:10.1111/jebm.12323 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46226
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Title
Atrial fibrillation following heart transplantation: A systematic review and meta-analysis of observational studies
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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.