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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation

Published on: April 27, 2019

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Interventricular conduction disorders after orthotopic heart transplantation: risk factors and clinical relevance

Sonia Ferretto1, Elvin Tafciu1, Immacolata Giuliani1

  • 1Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|September 10, 2016
PubMed

Insights

Right bundle branch block (RBBB) is the most common interventricular conduction disorder (IVCD) after heart transplant. RBBB is linked to acute rejection and heart positioning but does not impact patient prognosis.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Electrophysiology

Background:

  • Interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) lack established causes and significance.
  • Understanding post-transplant IVCDs is crucial for patient management.

Purpose of the Study:

  • To investigate the incidence, causes, and prognostic implications of IVCDs following OHT.
  • To compare IVCD prevalence between bicaval and biatrial anastomosis techniques.

Main Methods:

  • Retrospective analysis of 240 patients undergoing bicaval OHT, assessing IVCDs at day 1, 1 year, and 3 years post-transplant.
  • Inclusion of a biatrial anastomosis control group to evaluate surgical technique impact.
  • Correlation of IVCD presence and development with pre-transplant hemodynamics and post-transplant acute rejection scores.

Main Results:

  • Right bundle branch block (RBBB) was the most frequent IVCD.
  • Day 1 RBBB correlated with pre-transplant transpulmonary gradient.
  • RBBB incidence after 1 year and its development correlated with acute rejection (≥2 score).
  • Higher RBBB incidence observed in the biatrial control group compared to bicaval OHT.

Conclusions:

  • RBBB is the predominant IVCD post-OHT, influenced by surgical factors, heart positioning, pressure overload, and acute rejection.
  • Despite its occurrence, IVCDs, including RBBB, do not appear to adversely affect long-term prognosis after OHT.
Abstract

Keywords:
clinicalclinical noninvasive techniques-electrocardiographyelectrophysiology-conduction disturbances

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