New-onset secondary AF occurred in 1.2% of HSCT survivors within 30 days, with all experiencing recurrence during long-term follow-up.
Although secondary atrial fibrillation is rare immediately following haematopoietic stem cell transplantation, it carries a 100% recurrence rate, highlighting a persistent arrhythmic burden in these survivors.
Absolute Event Rate: 0% vs 0%
Abstract Background Haematopoietic stem cell transplantation (HSCT) induces a systemic inflammatory response, that may trigger atrial fibrillation (AF). Data on the incidence and impact of AF secondary to HSCT are scarce. Purpose To investigate the incidence and impact of secondary AF post-HSCT. Methods 599 HSCT survivors were enrolled into the monocentric COAST cohort study. New-onset AF was considered secondary when occurring up to 30 days post-HSCT without a prior diagnosis of AF. Medical records were used to collect demographic information and medical history. Vital parameters were measured during the annual post-HSCT clinical visit. Longitudinal follow-up (FU) assessments were done to record patient outcome, adverse cardiovascular (CV) events and AF-specific therapeutic interventions. Results Overall, 235 (39.2%) patients were female with a mean age of 59±13.96 years and a mean follow-up of 13.9 years. 19 (3.2%) patients had an AF diagnosis prior to HSCT. Within 30 days after HSCT, 7 (1.2%, 6 paroxysmal and 1 persistent) patients developed new-onset, secondary AF. All patients with AF experienced AF recurrence (4.4% of total population), whether pre-existing or secondary to HSCT. All patients with secondary AF were anticoagulated. During the FU period 8 AF patients underwent an electrical cardioversion for their AF, 2 of whom later underwent a pulmonary vein isolation due to further AF recurrence. Regarding other CV outcomes, 17 (5.5%) patients experienced a stroke or transient ischemic attack (2.9% ischemic, 1.3% haemorrhagic, 1.3% transient ischemic attack). 16 (2.7%) patients suffered a myocardial infarct, 18 (3.0%) were hospitalised due to heart failure and 67 (11.2%) patients died (6.3% non-CV, 1.5% CV, 4.7% unknown). Conclusions New-onset secondary AF occurred in a small proportion of HSCT survivors, but all affected individuals experienced recurrence, highlighting a persistent arrhythmic burden. Besides AF, these patients experience a high rate of CV events during long-term follow-up.The COAST-AF study; a graphical abstract
Bulatova et al. (Sat,) reported a other. New-onset secondary AF occurred in 1.2% of HSCT survivors within 30 days, with all experiencing recurrence during long-term follow-up.