Early and Late Indications for Implantation of Cardiac Pacemakers in Patients After Heart Transplantation: A Single-Center Experience

Abstract Background Data regarding the incidence and predictors of permanent pacemaker (PPM) implantation following cardiac transplantation are still limited and inconsistent. The aim of our study was to assess the incidence and indications for PPM implantation in cardiac transplant recipients in a single center. Methods We retrospectively analyzed the records of 508 consecutive patients including 425 men and an overall mean age of 45 y who underwent heart transplantation from 1988 to 2011 at our institution, using the biatrial surgical technique. Results Twenty-three (4.5%) subjects developed intermittent third-degree atrioventricular block (AVB) or sinus node dysfunction (SND) requiring PPM: 7 early (3 months) after transplantation. The incidence of AVB was higher than SND early (0.98% vs 0.4%; P < .05) and late (2.4% vs 0.8%; P < .01). The time from transplantation to PPM implantation was shorter among the SND group compared with the AVB group early (mean, 4.5 vs 6.5 weeks; P < .05) and late (mean, 4 vs 7 years; P < .05). Conclusion The incidence of PPM after heart transplantation was 4.5%. AVB was the main indication for PPM early and late after transplantation. The time interval from transplantation to PPM implantation was shorter among SND compared with AVB patients.