Preexisting atrial fibrillation and cardiac complications after liver transplantation

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and it is associated with increased cardiovascular morbidity and all-cause mortality. Our aim was to determine the impact of preexisting AF on patients undergoing liver transplantation (LT). A retrospective case-control study was performed. Records from patients who underwent LT between January 2005 and December 2008 at Mayo Clinic Florida were reviewed. Patients with preexisting AF were identified and matched to patients who did not have a diagnosis of AF. Thirty-two of 717 LT recipients (4.5%) had AF before LT. These patients were compared to a control group of 63 LT recipients. Pre-LT left ventricular hypertrophy (P=0.03), a history of congestive heart failure (P=0.04), and a history of stroke or transient ischemic attack (P=0.03) were significantly more prevalent in patients with AF versus controls. Intraoperative adverse cardiac events (P=0.02) and AF-related adverse postoperative events (P<0.001) were more common in the recipients with known AF. Six patients with paroxysmal AF (19%) developed chronic/ persistent AF postoperatively. Graft survival and patient survival were similar in the groups. Although patients with AF had a higher incidence of intraoperative cardiac events, a higher cardiovascular morbidity rate, and a complicated postoperative course, this did not affect overall graft and patient survival.