ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
New conduction defects and pacemaker implantation after heart transplantation
Çağatay Engin1, Serkan Ertugay1, Hatice Soner Kemal2, Hatice Şahin3, Tahir Yağdı1, Yaprak Engin4, İlknur Akdemir5, Sanem Nalbantgil2, Mustafa Özbaran1
1Departments of Cardiovascular Surgery, Medical Faculty of Ege University, İzmir, Turkey
2Departments of Cardiology, Medical Faculty of Ege University, İzmir, Turkey
3Departments of Medical Education, Medical Faculty of Ege University, İzmir, Turkey
4Department of Cardiovascular Surgery, Tepecik Training and Research Hospital, İzmir, Turkey
5Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.11889
Background: This study aims to determine the incidence of new conduction defects and pacemaker implantation and to identify patient characteristics for a permanent pacemaker need after biatrial orthotopic heart transplantation.

Methods: Between February 1998 and August 2014, we retrospectively analyzed the data of 212 consecutive patients (147 males, 65 females; mean age 39.6±15 years; range 5 to 65 years) who underwent heart transplantation with biatrial cuff technique in our clinic. Baseline characteristics and postoperative data were compared among the patients who required a pacemaker or did not.

Results: The incidence of permanent pacing after heart transplantation was 6.4%. The most frequent reason for permanent pacing was symptomatic bradycardia. Previous cardiac surgery was associated with a non-significant trend toward a need for permanent pacing (p=0.056). The presence of a ventricular assist device was a found to be associated with both prolonged temporary and permanent pacemaker requirement after biatrial cardiac transplantation (p=0.021 and p=0.042, respectively).

Conclusion: Although bradyarrhythmia and need for temporary pacing were common in the early postoperative period, few of these patients needed permanent pacemaker implantation. The need for a permanent pacemaker seems to be more frequent after challenging operations, such as bridge to heart transplantation with a long-term ventricular assist device.

Keywords : Bradycardia; heart transplantation; pacemaker
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