Objectives: In two patients with orthotopic heart transplantation, the surface electrocardiogram suggested interaction between the donor right atrium and the recipient right atrium. An electrophysiologic investigation was performed to assess possible atrioatrial conduction.
Background: After orthotopic heart transplantation, both recipient and donor atrial activities are usually independent, but in humans they may synchronize for short periods during exercise.
Methods: Electrophysiologic recordings were made using standard techniques. The atrial electrode locations (anterior for the donor and posterior for the recipient right atria) were confirmed by fluoroscopy. Incremental and programmed donor and recipient right atrial pacing protocols were performed.
Results: Unidirectional conduction between native and graft atria occurred in both patients. This phenomenon was evident at rest, during normal sinus rhythm and at various pacing rates, resulting in frequent atrial bigeminy and trigeminy.
Conclusions: Possible atrioatrial conduction after orthotopic heart transplantation may potentially be arrhythmogenic for the chamber where extrasystoles occur. This should be taken into account in attempting to devise new pacing modes if both atria are rendered electrically common.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/0735-1097(94)90561-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Lung protective ventilation guided by driving pressure improves pulmonary outcomes in heart transplantation.
Sci Rep
January 2025
Department of Cardiovascular Surgery , Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fujian, 350001, Fuzhou, China.
This study aimed to investigate whether driving pressure-guided ventilation can reduce postoperative pulmonary complications in patients who have undergone heart transplantation. Patients who underwent orthotopic heart transplantation were divided into two groups according to the perioperative ventilation strategy: (1) conventional lung-protective ventilation (group C) and (2) driving pressure-guided ventilation (group D). The primary outcome was the occurrence of postoperative pulmonary complications within 30 days of surgery.
View Article and Find Full Text PDFIncidence and risk factors for rejection after conversion from calcineurin inhibitor to sirolimus-based immunosuppression in orthotopic heart transplant recipients.
J Heart Lung Transplant
December 2024
Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester MN, 55905; Deparment of Cardiovascular Medicine, Mayo Clinic, Rochester MN, 55905. Electronic address:
Background: Although recommended in International Society for Heart and Lung Transplantation (ISHLT) guidelines, transition to mammalian targets of rapamycin (mTOR) inhibitors in heart transplant recipients is not routinely performed, in part due to perceived risk of rejection. This study sought to evaluate the incidence and risk factors for biopsy-proven, clinically relevant rejection following conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) immunosuppression.
Methods: A single center retrospective study was conducted of all consecutive adult patients who underwent orthotopic heart transplantation (OHT) and CNI-free SRL conversion from January 1999 to January 2023.
Systolic Anterior Motion of the Mitral Valve Post-Heart Transplant Secondary to an Unusual Mechanism.
Cureus
November 2024
Department of General Surgery, University of Virginia, Charlottesville, USA.
In this case report, we discuss the critical interdependence of structure and function in demonstrating systolic anterior motion (SAM) of the mitral valve after repeat heart transplantation, where residual apical tissue of the explanted heart remained in place. The resulting conformational changes led to anterior displacement of the mitral valve and persistent SAM.
View Article and Find Full Text PDFThe Impact of Donor Obesity on Outcomes of Donation After Circulatory Death Heart Transplantation.
J Thorac Cardiovasc Surg
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA.
Objectives: In the setting of the obesity epidemic and donor organ shortage in the United States, there's a growing need to expand the donor organ eligibility criteria for orthotopic heart transplantation (OHT). Donation after circulatory death (DCD) has emerged as a promising solution, but the outcomes with obese donor hearts in DCD remains unknown.
Methods: Using the UNOS registry between 2019 and 2024, recipients of DCD OHT were stratified into three donor obesity categories by body mass index (BMI): underweight/normal (BMI <25kg/m), overweight (BMI 25-30kg/m), and obese (BMI >30kg/m).
Pediatric Extracorporeal Membrane Oxygenation in Restrictive and Hypertrophic Cardiomyopathy: A Single Center Experience.
ASAIO J
October 2024
From the Division of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Patients with restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) were previously considered poor candidates for mechanical circulatory support due to technical limitations related to restrictive ventricular physiology and small ventricular size, limiting the ability to provide adequate flows and decompress the heart. Literature examining use of extracorporeal membrane oxygenation (ECMO) in this population consists of a single case series reporting no survivors. We report our experience providing ECMO in children with RCM or HCM at a large pediatric quaternary cardiac center.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!