Introduction
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, affecting almost 30 million people worldwide and expected to reach 50 million people worldwide in 20501, 2. Patients with AF have a higher risk of reduced survival and adverse cardiovascular and cerebrovascular events3, 4. These epidemiological estimates could be extended to organ transplant recipients. Studies show that end-stage renal disease and end-stage hepatic disease patients who receive organ grafting have an AF prevalence of 7.0% and 5.6%, respectively, and these values are higher than that of the general population (1%-2%)5-8. In addition, studies have demonstrated pooled incidences of post-kidney transplant AF and post-liver transplant AF of 4.9% and 8.5%, respectively7, 8.
Because of ongoing improvements in surgery and medicine, the number of organ transplant patients is steadily increasing9, 10. These transplant recipients usually carry multiple comorbidities and require individualized treatment. Previous studies have shown that AF is associated with inferior survival in abdominal solid organ transplant recipients11-13. In addition, the treatment of AF in solid organ transplant recipients by using antiarrhythmic drugs (AADs) is often difficult14-17, and non-vitamin K antagonist oral anticoagulants (NOACs) may interact with immunosuppressive agents18, 19. Therefore, a more reliable treatment for AF in solid organ transplant recipients is needed.
In recent years, catheter ablation (CA) for AF has proven to be a safe and effective treatment strategy for patients with symptomatic AF20. However, the feasibility and outcomes of CA in abdominal solid organ transplant recipients with AF remain unclear. In the present study, we aimed to elucidate the feasibility, efficacy and safety of CA in renal and hepatic transplant recipients.