Safety and efficacy of catheter ablation for atrial fibrillation in
abdominal solid organ (renal and hepatic) transplant recipients: a
single-center pilot experience
Abstract
Background: Atrial fibrillation (AF) is common in abdominal solid organ
transplant recipients and a cause of morbidity and mortality in this
population. However, the outcomes of catheter ablation (CA) in
transplant recipients with AF remain unclear. This study aimed to
elucidate the outcomes of CA in renal and hepatic transplant recipients.
Methods and Results: Between 2015 and 2019, 14 transplant recipients (9
with kidney transplantation and 5 with liver transplantation) were
enrolled from among 10,741 AF patients and underwent CA at Anzhen
Hospital. Another 56 patients matched by age, sex and AF type were
selected as the control group (4 controls for each transplant
recipient). During a mean follow-up of 30.0±13.3 months after the
initial procedure, 10 (71.4%) of the transplant patients, compared to
41 (73.2%) of the control patients, remained free from AF
recurrence(P=1.000). A repeated procedure was performed in 1 transplant
patient and in 6 control subjects. Consequently, 11 (78.6%) of the
transplant patients, compared to 46 (82.1%) of controls, were in sinus
rhythm after the repeated ablation (P=0.715). Notably, Kaplan–Meier
analysis did not demonstrate any significant differences in the atrial
arrhythmia-free rate after the initial and repeated procedure between
the two groups. Vascular complications were identified in 1 transplant
patient and 2 control subjects, while no life-threatening complications
were observed in either group. There was no transient allograft
dysfunction in transplant recipients after CA. Conclusion: CA is safe
and effective in abdominal solid transplant recipients, and may be an
optimal therapeutic strategy for this group.