ECG-based detection of an atrial cardiomyopathy allows identification of patients at risk for postoperative supraventricular arrhythmias after lung transplant

Background Postoperative supraventricular arrhythmias (SVA) frequently occur after lung transplant (LTX) and are associated with an increased risk of morbidity and mortality. An atrial cardiomyopathy (ACM) is a known risk factor for new-onset SVA and can be detected non-invasively by measurement of the p-wave-duration on electrocardiogram (ECG). However, studies investigating the impact of ACM on the occurrence of SVAs in patients undergoing LTX are lacking.

Aims and objectives The aim of the current study is to investigate whether ECG-based ACM-detection is associated with the risk of postoperative SVAs in patients who underwent LTX.

Methods We retrospectively screened 134 patients who underwent first LTX at the University of Freiburg between 2014 and 2022. In 64 of these patients (median age: 60 years, 53% male), a digital ECG prior to LTX was available and patients survival was at least one month post LTX. P-wave duration has been measured after amplification of the digital ECG to 80 mm/mV and 175 mm/s. SVAs were defined as an episode lasting>30 seconds on telemetry monitoring on intensive care unit or diagnosed in 12-lead ECG on normal ward.

Results Postoperative SVAs occurred in 33 patients (52%) after LTX. The risk of SVAs was significantly associated with a prolonged p-wave duration with an increase of 6% with every millisecond duration (p=0.031) and remained significant after adjustment for age, sex and BMI (p=0.042).

Conclusions Detection of an ACM diagnosed by a prolonged p-wave duration in patients undergoing LTX allows to identify patients at risk for postoperative SVAs who should be monitored more closely.

 

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Publication History

Article published online:
01 March 2024