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Pulmonary vein (PV) conduction returned even after lung transplantation requiring full surgical resection and replacement of PVs, a single-center study found.

Among 704 patients with no atrial fibrillation (Afib) before transplant, 2.5% with a unilateral procedure and 3.3% with bilateral procedures developed Afib 6 months later, , of Cleveland Clinic, and colleagues reported online in .

Among the 51 with pre-existing Afib, the recurrence rates after transplant were 19.4% and 25.0% with unilateral and bilateral procedures, respectively.

Among the subset of patients who underwent left atrial ablation after transplant for recurrent refractory Afib (n=8), PV electrical conduction recovery -- a typical sign of failed catheter ablation for Afib -- was observed across surgical anastomosis lines in 22 of 26 previously-disconnected PVs. Conduction recovery was observed in at least one vein in all but one of these patients.

Re-isolation of the veins with additional substrate modification or flutter ablations successfully restored and maintained sinus rhythm in seven of the eight patients, Hussein's group noted.

"In lung transplant recipients, who undergo full surgical resection of the PVs, a prior history of Afib was associated with late Afib, regardless of whether patients underwent single or bilateral lung transplant," the authors concluded. "PV conduction recovery still occurred and was observed in most patients who underwent left atrial ablation procedures for recurrent Afib."

"One important caveat in the interpretation of our findings is that PV electrical conduction recovery rate in the subset of patients with recurrent refractory AF and left atrial ablations does not necessarily reflect the PV recovery rate in the overall population of transplant recipients."

Hussein's group analyzed data from 755 consecutive patients who received lung transplants from 2006 to 2013.

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