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Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why?
BACKGROUND: Orthotopic heart transplantation (OHT) is associated with a high incidence of conduction disturbances (CD) leading to permanent pacemaker (PPM) implantation. However, the improved posttransplant survival raises the question about the pacemaker dependence (PD) in a prolonged follow‐up. HY...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296793/ https://www.ncbi.nlm.nih.gov/pubmed/35670209 http://dx.doi.org/10.1111/anec.12979 |
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author | Alyaydin, Emyal Pogoda, Christian Dell'Aquila, Angelo Frommeyer, Gerrit Sindermann, Juergen R. Reinecke, Holger Tuleta, Izabela |
author_facet | Alyaydin, Emyal Pogoda, Christian Dell'Aquila, Angelo Frommeyer, Gerrit Sindermann, Juergen R. Reinecke, Holger Tuleta, Izabela |
author_sort | Alyaydin, Emyal |
collection | PubMed |
description | BACKGROUND: Orthotopic heart transplantation (OHT) is associated with a high incidence of conduction disturbances (CD) leading to permanent pacemaker (PPM) implantation. However, the improved posttransplant survival raises the question about the pacemaker dependence (PD) in a prolonged follow‐up. HYPOTHESIS: The prevalence of PPM in OHT is high but not all patients are PD in a very long‐term follow‐up. Device implantation has no prognostic relevance. METHODS: We performed a retrospective analysis of patient medical records focusing on device interrogation data at the most recent follow‐up. RESULTS: The study population consisted of 183 patients with a mean follow‐up of 15.0 ± 6.8 years. One‐fourth of the patients had undergone PPM implantation (n = 49, 26.8%). Among these, two‐thirds were PD at last follow‐up (n = 32, 65.3%). PPM was more often in biatrial OHT and cardiac allograft vasculopathy (OR 3.0, 95% CI 1.26–7.29, p = .013 and OR 2.0, 95% CI 1.03–3.87, p = .041, respectively). Early sinus node dysfunction (SND) was the most persistent CD. PPM was associated with a poorer outcome in OHT (HR 1.9, 95% CI 1.06–3.46, p = .031) and a higher rate of fatal septicemia (HR 5.1, 95% CI 1.41–18.14, p = .013). CONCLUSIONS: One‐fourth of the OHT recipients develop CD requiring PPM implantation, although one‐third among these are not PD in follow‐up. Early SND is associated with a higher rate of PD. PPM is associated with an inferior prognosis. |
format | Online Article Text |
id | pubmed-9296793 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92967932022-07-20 Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? Alyaydin, Emyal Pogoda, Christian Dell'Aquila, Angelo Frommeyer, Gerrit Sindermann, Juergen R. Reinecke, Holger Tuleta, Izabela Ann Noninvasive Electrocardiol Original Articles BACKGROUND: Orthotopic heart transplantation (OHT) is associated with a high incidence of conduction disturbances (CD) leading to permanent pacemaker (PPM) implantation. However, the improved posttransplant survival raises the question about the pacemaker dependence (PD) in a prolonged follow‐up. HYPOTHESIS: The prevalence of PPM in OHT is high but not all patients are PD in a very long‐term follow‐up. Device implantation has no prognostic relevance. METHODS: We performed a retrospective analysis of patient medical records focusing on device interrogation data at the most recent follow‐up. RESULTS: The study population consisted of 183 patients with a mean follow‐up of 15.0 ± 6.8 years. One‐fourth of the patients had undergone PPM implantation (n = 49, 26.8%). Among these, two‐thirds were PD at last follow‐up (n = 32, 65.3%). PPM was more often in biatrial OHT and cardiac allograft vasculopathy (OR 3.0, 95% CI 1.26–7.29, p = .013 and OR 2.0, 95% CI 1.03–3.87, p = .041, respectively). Early sinus node dysfunction (SND) was the most persistent CD. PPM was associated with a poorer outcome in OHT (HR 1.9, 95% CI 1.06–3.46, p = .031) and a higher rate of fatal septicemia (HR 5.1, 95% CI 1.41–18.14, p = .013). CONCLUSIONS: One‐fourth of the OHT recipients develop CD requiring PPM implantation, although one‐third among these are not PD in follow‐up. Early SND is associated with a higher rate of PD. PPM is associated with an inferior prognosis. John Wiley and Sons Inc. 2022-06-07 /pmc/articles/PMC9296793/ /pubmed/35670209 http://dx.doi.org/10.1111/anec.12979 Text en © 2022 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Alyaydin, Emyal Pogoda, Christian Dell'Aquila, Angelo Frommeyer, Gerrit Sindermann, Juergen R. Reinecke, Holger Tuleta, Izabela Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title | Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title_full | Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title_fullStr | Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title_full_unstemmed | Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title_short | Permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: A matter of when or why? |
title_sort | permanent pacing in a very long‐term follow‐up after orthotopic heart transplantation: a matter of when or why? |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296793/ https://www.ncbi.nlm.nih.gov/pubmed/35670209 http://dx.doi.org/10.1111/anec.12979 |
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