Cardiovascular Implantable Electronic Devices -> Monitoring & Outcomes: -> Monitoring & Follow-up D-MP07 - The A Through Z for CIEDs (ID 55) Moderated ePoster

Abstract

Background: Sudden cardiac death (SCD) is a cause of long-term death in heart transplant recipients. However, little is known about the incidence of SCD in this particular population.
Objective: To assess the incidence of SCD after heart transplantation.
Methods: We enrolled 1,363 consecutive patients transplanted between 2004 and 2017 in two French centers. We defined 7 main groups of causes of deaths: SCD, cardiovascular, infection, primary graft dysfunction, graft failure, malignancy and others. Causes of deaths were independently adjudicated by two senior cardiologists based on the analysis of death certificates and medical records. SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms.
Results: A total of 1,363 patients were included. The median follow-up post-transplant was 3.99 years (IQR=0.49-7.49). 450 patients (33%) deceased during the first year. The leading causes of death in the first year after transplantation are infection, primary graft failure in intensive care unit. Beyond the post-operativ high-risk period of the first year, the leading cumulative cause of death is SCD in heart transplant recipients. Among the 213 deaths that occurred beyond the first year, 44 patients (21%) died from SCD. In this period, the incidence rate of SCD reached 0,82 per 100 person-year (95% CI: 0.51-2.05).
Conclusion: In a large multicentric cohort of heart transplant recipients, the leading cumulative cause of death beyond the first-year post transplant was sudden cardiac death. The implantation of cardioverter-defibrillators in this population should be discussed.
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