The influence of cardiac rhythm type and frequency on the prognosis of severe heart failure patients initially qualified for heart transplantation

Background: Atrial fibrillation(AF) is the most common arrhythmia among patients (pts) with heart failure and has significant influence on survival. Aim of the study: to assess prognosis of pts with refractory heart failure (HF) qualified for heart transplantation (HTX). Material/Methods:872 pts (107 W and 765 M) were qualified for HTX between Dec 2003 and Oct 2007. Patient's death or super urgent heart transplantation were considered the end point in Kaplan-Meier survival curves. Results:680 pts were on sinus rhythm (SR) and 192(22.0%) had atrial fibrillation (AF). During follow up (1-1464 days, mean 550 days) 155pts (17.7%) died, 17.65% with SR and 18.23% with AF (ns). EF - mean 21,6 (SR) and 21,8 (FA), NYHA 3,1 (SR), NTproBNP- mean 3635, 4 (SR) and 4349,4 (FA), Arronson - mean 7,8 (SR) and 7,7 (FA). There were no significant differences between groups. We analyzed influence of heart rate (Kaplan-Maier method) on survival. The pts were divided according to HR: gr.I <70/min, gr II 71-89/min, gr III >90/min. The shortest survival rate was noticed in group III. There was no difference in survival between group I and II. Conclusions: The prognosis for patients qualified for heart transplant does not depend on the type of the dominant cardiac rhythm (atrial fibrillation or sinus rhythm). The prognosis is significantly better for those patients whose basic, resting heart rate does not exceed 90 bpm regardless of the rhythm type.