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Sinus node function after cardiac transplantation

C D Scott1, J H Dark, J M McComb

  • 1Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, England, United Kingdom.

Journal of the American College of Cardiology
|November 1, 1994
PubMed
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Sinus node dysfunction after heart transplant is less common than previously thought, with automaticity improving over time. Temporary pacing needs within weeks of transplant predict long-term pacemaker requirements.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Transplantation Medicine

Background:

  • Sinus node dysfunction (SND) and bradyarrhythmias are common post-cardiac transplant.
  • Previous studies reported high SND incidence (approx. 50%) but lacked serial data.
  • The natural history of SND after transplantation remained undescribed.

Purpose of the Study:

  • Examine temporal changes in sinus node function post-cardiac transplant.
  • Determine the incidence, natural history, and etiology of SND in transplant recipients.
  • Identify early predictors of long-term sinus node function.

Main Methods:

  • Serial electrophysiologic studies of sinus node function in 40 adult recipients.
  • 24-h ambulatory electrocardiographic (Holter) monitoring at 1, 2, 3, and 6 weeks, and 3 and 6 months post-transplant.

Related Experiment Videos

  • Assessment of sinus node recovery time and sinoatrial conduction.

    • Main Results:

    • Overall incidence of SND was 17.5% (7/40 patients).
    • Most cases of SND were identified within the first week, with one developing at 3 months.
    • Temporary pacing requirements during Holter monitoring at 2-3 weeks predicted the need for permanent pacing.

    Conclusions:

    • The incidence of SND after cardiac transplantation is lower than previously reported.
    • Sinus node automaticity generally improves over time post-transplant.
    • Early temporary pacing needs are the best predictor of long-term pacing requirements.