Pacemaker Therapy for Early and Late Sinus Node Dysfunction in Orthotopic Heart Transplant Recipients: A Single‐Center Experience

Abstract

Although frequently seen as an early complication of OHT, SND remains a risk throughout the lifetime of OHT recipients. Its mechanism is likely multifactorial, and whether this risk can be mitigated over the long term by newer techniques such as bicaval anastamoses remains to be established.

Permanent Pacing for Late‐Onset Atrioventricular Block in Patients with Heart Transplantation: A Single Center Experience

“…Unfortunately, we were unable to determine the interaction between ischemic time and donor and recipient age, as multivariate analyses were not feasible with the small number of cases in this study. We also found no association between late‐onset AV block and acute cellular rejection and CAV, as reported by other studies 6,13 . Hence, although we were unable to identify the mechanism of late‐onset AV block, late‐onset SND and AV block appears unlikely to be related to surgical trauma 13 …”

“…Some studies suggested late‐onset SND and others AV block as the dominant indication for permanent pacing, although the number of patients were generally small (Table III). 4 , 7–11 , 13–16 This study, with 27 patients who required permanent pacing >3 months from heart transplant (13 [48.2%] due to SND and 14 [51.8%] due to AV block) add to these previous reports and suggest that both SND and AV block may contribute equally to the need for permanent pacing late after heart transplantation.…”

“…Our data are consistent with other studies of late‐onset heart block in orthotopic transplantation (ranging from 1.0% to 3.2%), with time to permanent pacemaker implantation ranging from 6 to 122 months (Table III). 4 , 6–14 …”

“…Our data are consistent with other studies of late-onset heart block in orthotopic transplantation (ranging from 1.0% to 3.2%), with time to permanent pacemaker implantation ranging from 6 to 122 months (Table III). 4,[6][7][8][9][10][11][12][13][14] Some studies suggested late-onset SND and others AV block as the dominant indication for permanent pacing, although the number of patients were generally small (Table III). 4,[7][8][9][10][11][13][14][15][16] This study, with 27 patients who required permanent pacing >3 months from heart transplant (13 [48.2%] due to SND and 14 [51.8%] due to AV block) add to these previous reports and suggest that both SND and AV block may contribute equally to the need for permanent pacing late after heart transplantation.…”

Sinus node dysfunction after heart transplantation—An analysis of risk factors and atrial pacing burden

“…It is interesting to note that most patients developing SND required their pacemaker within the first 80 days (104 patients, 88%) while only 14 patients required pacemakers later. Luebbert et al presented data showing that in their post‐transplant SND cohort, 58% of the patients required a pacemaker within the first 30 days—in our study, 54% of the patients had received their pacemaker for post‐transplant SND within the first 30 days. A graphical representation of the time of pacemaker implantation in our cohort is shown in Figure .…”