Author + information
- Received April 21, 2020
- Revision received June 12, 2020
- Accepted June 27, 2020
- Published online August 17, 2020.
- Ersilia M. DeFilippis, MDa,∗,
- Geoffrey Rubin, MDa,∗,
- Maryjane A. Farr, MDa,
- Angelo Biviano, MD, MPHa,
- Elaine Y. Wan, MDa,
- Koji Takeda, MD, PhDb,
- Hasan Garan, MDa,
- Veli K. Topkara, MD, MSca and
- Hirad Yarmohammadi, MD, MPHa,∗ ()
- aDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- bDivision of Cardiothoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York
- ↵∗Address for correspondence:
Dr. Hirad Yarmohammadi, Columbia University Irving Medical Center, 177 Fort Washington Avenue, Room 637, New York, New York 10032.
• SCD occurs in approximately 10% of HT recipients.
• Rates of early SND after HT have significantly decreased with bicaval anastomosis compared with biatrial anastomosis.
• Data are mixed regarding the role of primary prevention ICDs after HT.
• Implantable cardiac monitors may be useful in detecting arrhythmias as a cause of syncope after HT.
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.
↵∗ Drs. DeFilippis and Rubin contributed equally to this work and are joint first authors.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received April 21, 2020.
- Revision received June 12, 2020.
- Accepted June 27, 2020.
- 2020 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.