Article: Trends and Outcomes of Atrial Fibrillation-Flutter Hospitalizations Among Heart Transplant Recipients (From the National Inpatient Sample)

Authors: Dinesh Voruganti, MD, Ghanshyam Shantha, MD, MPH, Sushma Dugyala, MD, Naga Venkata Krishna Pothineni, MD, Kanishk Agnihotri, MD, Behnam Bozorgnia, MD, Aman Amanullah, MD, Michael Giudici, MD, Alexandros Briasoulis, MD, PhD

Journal: Am J Cardiol 2020;125:87−91

Abstract:
Atrial fibrillation-flutter (AF) has been described in 10% to 24% of patients after heart transplant (HT). Data on AF hospitalizations after HT are limited to single-center experiences. To bridge this gap, we performed an analysis of admissions for AF in HT patients from the National Inpatient Sample (NIS) years 2000 to 2014. All hospitalizations with aprimary diagnosis of 427.31 or 427.32 and V42.1 were used to identify hospitalizations with AF and previous HT respectively. Among a total of 211,961 HT related hospitalizations, 1,304 (0.62%) (955 males, 349 females, mean age 59 years, median CHA2DS2Vascscore 2 [Interquartile range 1 to 3]) were admitted with a primary diagnosis AF. Most hospitalizations were nonelective (80.17%). In-hospital mortality was 2.3% and the meanlength of stay (LOS) was 3.7 days. Among those patients who were discharged from hospital, 85 % were discharged to home with self-care. Most commonly reported secondary diagnoses included hypertension (57.9%), diabetes (33%), renal failure (31.3%), and congestive heart failure (22%). The event rates for ischemic stroke and gastrointestinal bleeding in the same admission with the AF hospitalization were low (1.2% and 1.2%respectively). Cardioversion was performed in 37% and ablation in 11.2% of admissions.The adjusted median cost of hospitalization was $6478.7 (IQR $3561.8 to $12352.3) and did not change significantly during the study period. AF is a relatively infrequent cause of hospitalization among HT recipients. The number of hospitalizations, ablations, cardio-versions, disposition, LOS, and cost of hospitalization for AF remained stable during the study period.

Link to journal online:
https://www.ajconline.org/article/S0002-9149(19)31107-5/fulltext