Key result
Permanent pacemaker implantation occurs in ~8% of heart transplant recipients, predicted by older donor age.
Why the study?
In the modern era of orthotopic heart transplantation with bicaval anastomosis, there is a paucity of data on permanent pacemaker implantation in this population.
Cohort (n=370)
No
This study provides contemporary insights into the 8.1% incidence of permanent pacemaker requirement following bicaval orthotopic heart transplantation, identifying older donor age as a key risk factor.
In the modern era of orthotopic heart transplantation (OHT) with bicaval anastomosis, there is paucity of data on permanent pacemaker implantation (PPI) on this population. This is a retrospective study describing the incidence, indication and predictors in patients who underwent PPI after OHT. Using the transplant database from our institution between January 2016 and December 2022, 370 patients who had de-novo OHT were identified. The incidence of PPI post OHT was 8.1% (n=30 patients). The average time from OHT to PPI was 30.5 days. The most common indication for PPI was sinus node dysfunction (SND), accounting for 83% of cases. Regarding predictors for PPI, multivariate analysis identified donor age as an independent predictor (HR 1.05, 95% CI 1.01-1.09, p=0.02). However, factors including recipient age, ischemic time, sex, underlying cardiomyopathy, body mass index, mechanical support, pre-transplant length of stay, and post-OHT length of stay, did not show significant predictive value.
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Asemota et al. (2025) conducted a cohort in End-stage heart failure requiring orthotopic heart transplantation (n=370). Orthotopic heart transplantation with bicaval anastomosis was evaluated on Incidence of permanent pacemaker implantation post-transplant. The incidence of permanent pacemaker implantation after orthotopic heart transplantation was 8.1%, and older donor age was identified as an independent predictor of requiring a pacemaker (HR 1.05).
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