Arrhythmias & electrophysiology
Incidence, predictors, and outcomes of atrial fibrillation and stroke after heart transplantation
- retrospective study
- high-volume center
+1 more
- high-volume center
Authors' conclusion
AF after HT is associated with reduced long-term survival. Both donor and recipient factors contribute, and donor age-derived CHA2DS2-VASc scoring may aid risk stratification and surveillance.
Study context
- Population
- Adult patients who underwent heart transplantation (HT) at a high-volume center between January 1, 2005, and September 30, 2024median age 55 years [interquartile range 45–63], 75% male
- Participants
- 1,072 patients
- Exposure
- Patients with atrial fibrillation (AF) after HT vs patients without AF
- AFn = 111
Main finding
As reported in the abstract
AF incidence after HT
AF occurred, most commonly as late or combined early and late AF
11% (n = 111)
Observational data: associations, not effects.
Further findings
Survival · 5 years · lower in patients with AF
P < 0.01
Predictors of early AF
- Donor age, post-HT extracorporeal membrane oxygenation, and pericardial effusion predicted early AF
Predictors of late AF
- Rejection, cardiac allograft vasculopathy, and early AF predicted late AF
Stroke
- Stroke occurred
- 9% of patients
- Independently associated with pre-HT mechanical circulatory support and ischemic time but not AF
CHA2DS2-VASc scores
- Scores incorporating recipient and donor factors predicted post-HT stroke; the donor-derived score also predicted AF
Survival · 5 years
- lower in patients with AF (72% vs 86%; P < .01)
Original publication
Incidence, predictors, and outcomes of atrial fibrillation and stroke after heart transplantation. Heart Rhythm. Published 24 February 2026. doi:10.1016/j.hrthm.2026.02.022
Summarised from the published abstract; every number is checked against it