Early Post-Operative Atrial Fibrillation after Lung Transplantation

Abstract

Atrial fibrillation (AF) is a common complication after lung transplantation that is associated with adverse outcomes. While some evidence-based protocols exist for prophylaxis and treatment of AF after general thoracic surgery, there lacks necessary evidence-based recommendations in the lung transplant population to standardize care delivery. This paucity of literature contributes to limited evidence-based guidelines for treatment and prophylaxis of AF in this specialty population. The purpose of this descriptive study was to identify the evidence-based practices for prophylaxis and treatment of AF at lung transplant centers across the United States and Canada after lung transplantation. A ten-item questionnaire was sent with the use of Qualtrics to lung transplant centers across the United States and Canada over a six-week period via email and list serve distribution. This study was reviewed and exempt by the Social and Behavioral Sciences Institutional Review Board. The reported incidence rates of AF varied per institution from less than ten percent to the highest rate at seventy percent. Of the twelve centers that completed the survey, four (26.7%) of the institutions reported the use of a standardized treatment protocol whereas eight (53.5%) did not. Regarding the use of a standardized prophylaxis protocol, three (20%) reported the implementation of specific protocols while; nine (60%) did not. An individualized protocol for post-operative AF was addressed in three (20%) cases. This study analyzed current practices for prophylaxis and treatment guidelines for the occurrences of AF, and found similarities to the transplant literature. Despite the implementation of prophylaxis and treatment protocols within various institutions, the reported rates of AF remain constant. Guidelines may decrease incidence, improve early recognition, decrease adverse outcomes, prevent potential complications, and standardize care delivery. Further research is needed to establish standards of practice for AF prevention and treatment in post-operative lung transplant patients.