Permanent pacing for late-onset atrioventricular block in patients with heart transplantation: a single center experience.

Abstract

INTRODUCTION:

The incidence, mechanisms, clinical associations, and outcomes in patients with late-onset (>3 months) atrioventricular (AV) block following heart transplantation are not well known. This study will characterize late-onset AV block following cardiac transplantation.

METHODS:

We retrospectively reviewed our databases to identify patients who required pacemakers for late-onset AV block postheart and heart-lung transplantation from January 1990 to December 2007. Orthotopic heart and heart-lung transplantation were separately analyzed.

RESULTS:

This study included 588 adults who received cardiac transplants over a 17-year period at our center (519 orthotopic, 64 heart-lung transplants, and five heterotopic heart transplants). Of the 519 patients with orthotopic heart transplant, 39 required pacing (7.5%), 17 (3.3%) within 3 months posttransplant, 11 (2.1%) for late-onset sinus node dysfunction (SND), 11 (2.1%) for late-onset AV block. Also, five patients (7.8%) out of 64 heart-lung transplants required pacemakers, two (3.1%) for late-onset SND, three (4.7%) for late-onset AV block. None of the five patients who underwent heterotopic transplant required cardiac pacing prior to or posttransplant.

CONCLUSIONS:

Late-onset AV block occurs in 2.4% of patients with orthotopic heart transplant or heart-lung transplant. AV block is predominantly intermittent and, often, does not progress to permanent AV block. There are no predictable factors for its onset.

• Authors: Andre E Tay, Steven Faddy, Sern Lim, Bruce D Walker, Dennis Kuchar, Charles W Thorburn, Peter Macdonald, Anne Keogh, Eugene Kotlyar, Alan Farnsworth, Chris Hayward, Paul Jansz, Emily Granger, Phillip Spratt, Rajesh N Subbiah
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 34 Issue 1 Pg. 72-5 (Jan 2011) ISSN: 1540-8159 [Electronic] United States
• PMID: 20946303 (Publication Type: Journal Article)
• Copyright: ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

Topics

• Atrioventricular Block (epidemiology, prevention & control)
• Australia (epidemiology)
• Cardiac Pacing, Artificial (statistics & numerical data)
• Female
• Heart Transplantation (statistics & numerical data)
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Complications (epidemiology, prevention & control)
• Risk Assessment
• Risk Factors
• Treatment Outcome