Talha A Farid1,2, Mohamed A Omer3, Kensey Gosch4, Ashley Moser3,4, Bethany Austin3,4, Anthony Magalski3,4, Alan P Wimmer3,4. 1. Department of Internal Medicine, University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO, USA. talha.farid@louisville.edu. 2. Department of Cardiovascular Medicine, University of Louisville, 201 Abraham Flexner Way, Louisville, KY, 40292, USA. talha.farid@louisville.edu. 3. Department of Internal Medicine, University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO, USA. 4. St. Luke's Mid America Heart Institute, Kansas City, MO, USA.
Abstract
BACKGROUND: A significant minority of cardiac transplant patients require permanent pacemaker (PPM) implant, primarily for sinus node dysfunction. The stability of pacing indices has not been determined in this unique patient population, and data regarding ongoing need for pacing are limited. METHODS: Pacing indices (sensing, threshold, and impedance) as well as the percentage of time patients required pacing were recorded, from 30 cardiac transplant patients that underwent PPM implant, over 1 year of follow-up. Repeated measure ANOVA (analysis of variance) was used to compare pacing indices and the percentage of time patients required pacing in each cardiac chamber (right atrium (RA) and right ventricle (RV)) and at different time points. RESULTS: There was no difference in sensing among the follow-up time points (p = 0.9). Thresholds at 3 months were significantly higher compared to the day of implant (p = 0.005) and the day after implant (p = 0.03). Impedances at implant were significantly higher compared to day 1 (p < 0.001), 3 months (p < 0.003), and 12 months (p < 0.001) post-implant. The mean percentage of RA pacing was 85 ± 6% the day after implant, 74 ± 6% at 3 months, and 80 ± 6% at 1 year (p = 0.17). CONCLUSION: In cardiac transplant patients, pacing impedances decrease and thresholds trend up in short-term follow-up, but subsequent sensing, threshold, and impedance remain stable at 1 year. This is comparable to the pattern observed among noncardiac transplant PPM recipients. The atrial pacing percentage was stable over 1 year, suggesting continued relative sinus node dysfunction.
BACKGROUND: A significant minority of cardiac transplant patients require permanent pacemaker (PPM) implant, primarily for sinus node dysfunction. The stability of pacing indices has not been determined in this unique patient population, and data regarding ongoing need for pacing are limited. METHODS: Pacing indices (sensing, threshold, and impedance) as well as the percentage of time patients required pacing were recorded, from 30 cardiac transplant patients that underwent PPM implant, over 1 year of follow-up. Repeated measure ANOVA (analysis of variance) was used to compare pacing indices and the percentage of time patients required pacing in each cardiac chamber (right atrium (RA) and right ventricle (RV)) and at different time points. RESULTS: There was no difference in sensing among the follow-up time points (p = 0.9). Thresholds at 3 months were significantly higher compared to the day of implant (p = 0.005) and the day after implant (p = 0.03). Impedances at implant were significantly higher compared to day 1 (p < 0.001), 3 months (p < 0.003), and 12 months (p < 0.001) post-implant. The mean percentage of RA pacing was 85 ± 6% the day after implant, 74 ± 6% at 3 months, and 80 ± 6% at 1 year (p = 0.17). CONCLUSION: In cardiac transplant patients, pacing impedances decrease and thresholds trend up in short-term follow-up, but subsequent sensing, threshold, and impedance remain stable at 1 year. This is comparable to the pattern observed among noncardiac transplant PPM recipients. The atrial pacing percentage was stable over 1 year, suggesting continued relative sinus node dysfunction.
Authors: A Trento; J M Takkenberg; L S Czer; C Blanche; S Nessim; M H Cohen; R Kass; S Raissi; J M Matloff Journal: J Thorac Cardiovasc Surg Date: 1996-12 Impact factor: 5.209
Authors: Mohamad H Yamani; Showkat A Haji; Randall C Starling; E Murat Tuzcu; Norman B Ratliff; Daniel J Cook; Ashraf Abdo; Tim Crowe; Michelle Secic; Patrick McCarthy; James B Young Journal: J Am Coll Cardiol Date: 2002-03-20 Impact factor: 24.094
Authors: Eric S Weiss; Lois U Nwakanma; Stuart B Russell; John V Conte; Ashish S Shah Journal: J Heart Lung Transplant Date: 2008-02 Impact factor: 10.247