Arrhythmias after pediatric lung transplantation

Atrial arrhythmias have been reported after congenital heart surgery involv ing extensive atrial suture lines. Experimental studies involving bilateral lung transplantation (Tx) suggest that the left atrial suture lines predis pose to atrial flutter. The overall incidence and type of arrhythmias after pediatric lung Tx have not previously been described and therefore the pur pose of this study was to prospectively screen and describe arrhythmias in a subset of our lung transplant population. Over a 1-yr study period, all r ecipients of bilateral lung Tx were admitted to a full-disclosure telemetry unit. Single-lead electrocardiograms were recorded continuously and review ed daily via a beat-by-beat analysis. A total of 314 patient days (range 9- 93, median 43 days) were recorded from seven patients. The incidence of arr hythmias observed per total patient days included junctional escape rhythm (4.8%), non-sustained ventricular tachycardia (4. 1%), accelerated junction al (2.5%), sinus bradycardia (2.2%), non-sustained supraventricular tachyca rdia (1.3%), ectopic atrial tachycardia (1.0%), sustained ventricular tachy cardia (0.3%), junctional ectopic tachycardia (0.3%), and second degree hea rt block (0.3%). No patient had sustained supraventricular tachycardia, (wh ich was also noted and treated prior to transplant). We conclude that among pediatric lung transplant recipients admitted for their transplant surgery , arrhythmia is uncommon and rarely requires therapy.