PULM4: Adverse Outcomes Associated With Atrial Arrhythmias After Venovenous Extracorporeal Membrane Oxygenation

Objectives: Venovenous extracorporeal membrane oxygenation (VV ECMO) is used as a treatment modality in those who fail to respond to conventional care. Hypoxia and medications used in the intensive care unit may increase risk for atrial arrhythmias (AA). This study aims to evaluate the impact of AA on post VV ECMO outcome. Methods: We conducted a retrospective review of patients who were placed on VV ECMO between October 2016 and October 2021. One hundred and forty-five patients were divided into AA and no AA. Baseline characteristic and potential risk factors were assessed. Uni and multivariate analysis using logistic regression models were constructed to evaluate the predictors of mortality between groups. Survival between groups was estimated by the Kaplan-Meier method using the log-rank test. Results: Age, history of hypertension and coronary artery diseases were significantly associated with AA development post VV ECMO (p value < 0.05). Length on ECMO, length on MV stay hospital length of stay, and sepsis were significantly increased in patients in the AA group (p-value <0.05). There was no difference in the overall mortality between the two groups. Conclusion: Advanced age with history of coronary artery disease and hypertension were associated with increased risk to develop AA post-VV ECMO placement. These arrhythmias were associated with prolonged placement of ECMO and MV, higher risk of sepsis and increased hospital resource utilization. Further studies needed to investigate potential strategies to prevent AAs development in this population.