Tachyarrhythmias after pediatric heart transplantation

Martin J. LaPage, Edward K. Rhee, Charles E. Canter

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Tachyarrhythmias in pediatric post-heart transplant patients are not well defined. In this study we sought to further characterize these arrhythmias in terms of presentation, course, and outcome. Methods: This investigation was a retrospective review of heart transplant recipients at St. Louis Children's Hospital during the period of 1991 to 2006. Patients were excluded if they were >18 years at transplantation or if follow-up information was unavailable. Patients with tachyarrhythmias beyond the first 2 weeks post-transplant were identified. Results: Twenty-eight tachyarrhythmias occurred in 25 of 237 heart transplant recipients. Freedom from arrhythmia was 92% at 1-year post-transplant and 86% at 15 years post-transplant. Intra-atrial reentry tachycardia (12 patients) and ectopic atrial tachycardia (10 patients) were the most common arrhythmias. Rejection was found in 3 (12%) and previously unrecognized coronary disease was found in another 2 (8%) at the time of presentation with arrhythmia. Fifteen of 25 (60%) were asymptomatic at presentation, but 4 of 25 (16%) presented with heart failure, including 3 without evidence of rejection. No risk factors for developing arrhythmia were identified. Twenty-one arrhythmias resolved with brief pharmacologic or no therapy. Only 3 had a recurrence after the initial arrhythmia. Five patients underwent catheter ablation. Conclusions: Our experience suggests that the presence of tachyarrhythmias after pediatric heart transplantation is not rare and usually not associated with rejection. Pediatric heart transplant recipients have a higher incidence of ectopic atrial tachycardia (EAT) than their adult counterparts. Most tachyarrhythmias resolve after a relatively brief period of medical treatment and recurrence is uncommon.

Original languageEnglish
Pages (from-to)273-277
Number of pages5
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2010

Keywords

  • arrhythmia
  • heart transplant
  • outcome
  • pediatric
  • supraventricular tachycardia

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