Cardiac Implantable Electronic Devices Following Heart Transplantation

Ersilia M. DeFilippis, Geoffrey Rubin, Maryjane A. Farr, Angelo Biviano, Elaine Y. Wan, Koji Takeda, Hasan Garan, Veli K. Topkara, Hirad Yarmohammadi

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Permanent pacemaker (PPM) implantation is required in a subset of patients (∼10%) for sinus node dysfunction or atrioventricular block both early and late after heart transplantation. The incidence of PPM implantation has decreased to <5% with the advent of bicaval anastamosis transplantation surgery. Pacing dependence upon follow-up has been variably reported. An even smaller percentage of transplantation recipients (1.5% to 3.4%) undergo implantable cardioverter-defibrillator (ICD) placement. Rigorous data are lacking for the use of ICDs in the transplantation population and is largely derived from cohort studies and case series. Sudden cardiac death occurs in approximately 10% of transplantation recipients, but multiple nonarrhythmic factors are believed to be responsible, including acute rejection, late graft failure with electromechanical dissociation, and ischemia due to cardiac allograft vasculopathy. This review provides a comprehensive analysis of the existing data regarding the role for PPMs and ICDs in this population, including leadless PPMs and subcutaneous ICDs, special considerations, and future directions.

Original languageEnglish (US)
Pages (from-to)1028-1042
Number of pages15
JournalJACC: Clinical Electrophysiology
Volume6
Issue number8
DOIs
StatePublished - Aug 2020
Externally publishedYes

Keywords

  • heart transplantation
  • implantable cardioverter-defibrillator
  • pacemaker
  • sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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