Arrhythmias in hematopoietic stem cell transplantation: A systematic review and meta-analysis

Eur J Haematol. 2019 Dec;103(6):564-572. doi: 10.1111/ejh.13322. Epub 2019 Oct 6.

Abstract

Background: There are controversial data regarding the relationship between hematopoietic stem cell transplantation and arrhythmias. This meta-analysis was performed to evaluate the incidence of arrhythmias in patients following hematopoietic stem cell transplantation (HSCT).

Methods: A literature search was conducted utilizing MEDLINE, EMBASE, and Cochrane Databases from inception through April 2019. Pooled incidence with 95% confidence interval (CI) were calculated using random-effects meta-analysis. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42019131833).

Results: Thirteen studies consisting of 10,587 patients undergoing HSCT were enrolled in this systematic review. Overall, the pooled estimated incidence of all types of arrhythmias following HSCT was 7.2% (95% CI: 4.9%-10.5%). With respect to the most common type of arrhythmia, the pooled estimated incidence of atrial fibrillation/atrial flutter (AF/AFL) within 30 days following HSCT was 4.2% (95% CI: 1.7%-9.6%). Egger's regression test demonstrated no significant publication bias in this meta-analysis of post-HSCT arrhythmia incidence.

Conclusion: The overall estimated incidence of arrhythmias following HSCT was 7.2%. Future large scale studies are needed to further elucidate the significance and clinical impact of arrhythmias in post-HSCT patients.

Keywords: atrial fibrillation; bone marrow transplantation; meta-analysis; stem cell transplantation; supraventricular tachycardia.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Arrhythmias, Cardiac* / classification
  • Arrhythmias, Cardiac* / epidemiology
  • Arrhythmias, Cardiac* / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Incidence