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Long-term intrinsic pacemaker function in patients paced for sinus node deficiency after cardiac transplantation
G Heinz1, C Kratochwill, P Buxbaum
1Department of Medicine II, University of Vienna, Austria.
Pacing and Clinical Electrophysiology : PACE
|November 1, 1992
Summary
Cardiac transplant patients needing pacemakers may not regain full sinus node function, even if sinus rhythm returns. Long-term monitoring is crucial before pacemaker adjustments.
Area of Science:
- Cardiology
- Transplantation Medicine
- Electrophysiology
Background:
- Sinus node (SN) insufficiency is a complication in cardiac transplant recipients, often necessitating permanent pacing.
- Assessing long-term SN function after transplantation is critical for managing these patients.
Purpose of the Study:
- To evaluate the long-term sinus node function in cardiac transplant recipients who received permanent pacemakers.
- To determine if the return of sinus rhythm correlates with normalized sinus node function.
Main Methods:
- Follow-up evaluation of 15 cardiac transplant recipients with permanent pacemakers (AAI, VVI, rate-responsive) for SN insufficiency.
- Assessment of sinus node recovery time and intrinsic rhythm at discharge and long-term follow-up (240-1,461 days).
Main Results:
- At follow-up, 11 patients were in sinus rhythm, but only 1 of 8 assessed had normal sinus node recovery time.
- Four patients who recovered sinus rhythm before hospital discharge had pathological SN recovery times.
- Three patients developed late symptoms requiring delayed pacemaker implantation despite apparent early normalization.
Conclusions:
- Return of sinus rhythm after cardiac transplantation does not guarantee normalization of sinus node function.
- Long-term monitoring is essential, as apparent early recovery may not reflect true sinus node function.
- These findings impact decisions regarding pacemaker exchange or explantation in this patient population.