https://doi.org/10.1007/s00392-025-02625-4
1LMU Klinikum der Universität München Medizinische Klinik und Poliklinik I München, Deutschland; 2LMU Klinikum der Universität München Herzchirurgische Klinik und Poliklinik München, Deutschland; 3LMU Klinikum der Universität München Med. Klinik u. Poliklinik, Interventionelle Elektrophysiologie München, Deutschland
Background:
With the publication of CASTLE-HTx Trial interventional treatment of symptomatic atrial fibrillation (AF) in end-stage heart failure patients was discussed widely. However concerns about severity of heart failure in the study collective were raised.
Purpose:
In our study we present the incidence and impact of AF in a real end-stage heart failure collective defined by active waiting for a heart transplant due to end-stage heart failure listed by EUROTRANSPLANT.
Methods:
We included all patients listed by EUROTRANSPLANT for a heart transplant because of end-stage heart failure. Patients already treated by assist-devices as LVAD were excluded according to CASTE-HTx Trial.
Results:
80 patients were included into our analysis. In this cohort 50% of patients had no diagnosis of AF or Atrial Flutter. In 18% of patients in our cohort AF occurred paroxysmal, in 14% AF was persistent, 8% had permanent AF and 10% atrial flutter (Figure 1). 29 of 42 (69%) patients with AF, were diagnosed already before listed for HTx. Only in 1 patient acute rhythmization was needed due to new onset of atrial flutter while on HTx-waiting list.
Conclusions:
In a real end-stage heart failure collective AF is often diagnosed in the course of progression of the disease and half of the patients already are diagnosed with AF when listed for HTx. However, AF is not a common cause for clinical worsening while listed for HTx.