Key result
Review notes PPM incidence in heart transplant recipients declining to <5%.
Why the study?
Data on the use of implantable cardioverter-defibrillators in heart transplant recipients are limited, and existing evidence on cardiac implantable electronic devices requires comprehensive analysis.
This review summarizes the incidence and role of permanent pacemakers and ICDs in heart transplant recipients, highlighting a decline in PPM need with modern surgical techniques.
Decline in PPM incidence to <5% may lessen routine device considerations post-transplant; leaves open optimal ICD strategies in contemporary recipients.
A fraction of patients (approximately 10%) undergoing heart transplantation require permanent pacemaker (PPM) implantation due to sinus node dysfunction or atrioventricular block, occurring either shortly after surgery or later. The incidence of PPM implantation has declined to less than 5% with the introduction of bicaval anastomosis transplantation surgery. Pacing dependency during follow-up varies among recipients. A smaller subset (1.5-3.4%) receives implantable cardioverter-defibrillators (ICDs), but data on their use in transplant recipients are limited, primarily from cohort studies and case series. Sudden cardiac death affects around 10% of transplant recipients, attributed to various nonarrhythmic factors such as acute rejection, late graft failure, and cardiac allograft vasculopathy-induced ischemia. This review offers a comprehensive analysis of the existing data concerning the role of PPMs and ICDs in this population, encompassing leadless PPMs, subcutaneous ICDs, unique considerations, and future directions.
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Khan et al. (2024) conducted a review in Heart transplantation. Cardiac Implantable Electronic Devices (PPMs and ICDs) was evaluated. This comprehensive review analyzes the role of permanent pacemakers and implantable cardioverter-defibrillators in heart transplant recipients, noting a decline in PPM incidence to <5%.
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