Supraventricular tachyarrhythmias after hematopoietic stem cell transplantation: incidence, risk factors and outcomes |
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Authors: | Hidalgo J D Krone R Rich M W Blum K Adkins D Fan M-Y Brown R Devine S Graubert T Blum W Tomasson M Goodnough L T Vij R DiPersio J Khoury H |
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Affiliation: | Division of Oncology, Section of BMT and Leukemia, and Division of Cardiology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA. |
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Abstract: | Recent studies suggest that cancer patients may be at increased risk for supraventricular tachyarrhythmias (SVTA). We have observed clinically significant SVTA in patients undergoing hematopoietic stem cell transplantation occurring at a median of 6 days post transplant, manifesting as atrial fibrillation/flutter or regular narrow-complex tachycardia and persisting for a median of 3 days (range, 0-8). All patients received aggressive medical therapy and/or electrical cardioversion to restore sinus rhythm and to re-establish hemodynamic stability. Non-Hodgkin's lymphoma (NHL) was the most common diagnosis (53%), and a case control analysis in those patients demonstrated that SVTA occurred in 12% of patients and was associated with older age and pre-existing cardiac conditions. In conclusion, patients undergoing HSCT are at moderate risk for developing SVTA, particularly older patients with a diagnosis of NHL. These arrhythmias are clinically significant, and are a marker for increased mortality and prolonged hospital stay. Additional studies are needed to identify high-risk patients who may benefit from prophylactic anti-arrhythmic therapy. |
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