Arrhythmias & electrophysiologyResearch article
Utilization and Outcomes of Permanent Pacemakers After Bicaval Heart Transplantation: A Large Institutional Experience
- Large Institutional Experience
- matched on sex, age, and transplant year
Authors' conclusion
Post-HT PPM implantation rates were low and unchanged since 2010. Most devices were implanted for sinus node dysfunction, with 44% implanted within 1 month post-HT. PPM placement was not associated with post-HT survival. Advanced organ donor age was associated with risk of PPM placement. Transvenous PPM complication rates were comparable to rates described in general populations. Leadless PPMs accounted for a substantial minority of PPM placements since their introduction in 2018, with no complications to date. Longer follow-up is needed to establish their long-term outcomes and safety in patients with HT.
Study context
- Population
- Bicaval heart transplantation recipients treated at a single institution from 2010 to 2025bicaval heart transplantation (HT) recipients (28% women), 66 (5%) received a permanent pacemaker (PPM)
- Participants
- 1,225 recipients
- Comparison
- PPM recipients compared with HT patients without PPMs matched on sex, age, and transplant year
- PPM recipientsn = 66
Main finding
As reported in the abstract
Patients who received a PPM
Sixty-six (5%)
Median HT-to-PPM time
4.3 months (interquartile range, 2 weeks to 4.8 years)
Further findings
Median post-HT survival · similar
P = 0.14
PPM indications
- Sinus node dysfunction
- 41 patients, 62%
- Atrioventricular block
- 19 patients, 29%
Predictor of PPM placement: older organ donor age
- Older organ donor age independently predicted PPM placement (odds ratio)
- 1.75; P =0.04
Leadless PPMs
- Patients who received leadless PPMs
- Thirteen (20%)
- Atrial leadless PPMs
- 3
- Dual-chamber leadless PPM
- 1
Safety
Transvenous PPM major complication requiring device extraction · 3.2 years of median follow-up
- Transvenous PPM with major complication requiring device extraction
- 1
Leadless PPM short-term complications · 1 year of median follow-up
- No short-term complications
Original publication
Summarised from the published abstract; every number is checked against it