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Related Experiment Videos

Permanent pacing after cardiac transplantation

C D Scott1, J M McComb, J H Dark

  • 1Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne.

British Heart Journal
|May 1, 1993
PubMed
Summary

Long-term pacemaker use in cardiac transplant recipients is uncommon, with only 28% of patients pacing long-term after reprogramming. The need for continuous pacing is difficult to predict and may relate to persistent sinus node dysfunction after the initial postoperative period.

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Area of Science:

  • Cardiology
  • Transplant Medicine
  • Electrophysiology

Background:

  • Cardiac transplant recipients may require permanent pacemakers due to sinus node dysfunction or atrioventricular block.
  • The long-term necessity and optimal pacing mode in these patients remain subjects of investigation.

Purpose of the Study:

  • To assess the long-term need for pacemaker implantation in cardiac transplant recipients.
  • To identify the optimal pacing mode for cardiac transplant patients requiring pacemakers.

Main Methods:

  • A retrospective review of patient records was conducted.
  • A prospective study involved 24-hour ambulatory electrocardiography before and after pacemaker reprogramming to minimize pacemaker use.
  • The study included 21 cardiac transplant recipients who received permanent pacemakers.

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Main Results:

  • 11% of eligible cardiac transplant recipients received pacemakers, primarily for sinus node dysfunction (62%) or atrioventricular block (38%).
  • Long-term pacing (3 years post-transplant) decreased significantly from 38% to 10%.
  • After reprogramming to 50 beats/min, only 28% of patients paced during a 24-hour recording; this was more common in those with sinus node dysfunction (36%) than atrioventricular block (14%).

Conclusions:

  • Long-term pacemaker use in cardiac transplant recipients is infrequent, with only 28% requiring continuous pacing.
  • The need for long-term pacing is not reliably predictable but may be associated with persistent sinus node dysfunction beyond the second postoperative week.
  • Pacemaker implantation later than 16 days post-transplant was associated with a higher likelihood of long-term use.