Heart transplantation electrocardiogram and pacing after cardiac transplantation

Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D.; Associate Editor-In-Chief:

EKG Findings Following Transplantation
Below is a 12 lead EKG shows accessory atrial activity (better seen in lead II at the end of the first complex in the middle between the second and third complex and after the third complex) due to some of the original sinus node still remains in addition to the donor sinus node after a cardiac transplant. Because of a suture line in the right atrium the ectopic atrial rhythm rarely conducts to the AV node. Right axis deviation and a rSR' which might suggest volume overload RVH also shown.

==ACC/AHA Guidelines- Recommendations for Pacing After Cardiac Transplantation (DO NOT EDIT) == {{cquote|

Class I
1. Permanent pacing is indicated for persistent inappropriate or symptomatic bradycardia not expected to resolve and for other Class I indications for permanent pacing. (Level of Evidence: C)

Class IIb
1. Permanent pacing may be considered when relative bradycardia is prolonged or recurrent, which limits rehabilitation or discharge after postoperative recovery from cardiac transplantation. (Level of Evidence: C)

2. Permanent pacing may be considered for syncope after cardiac transplantation even when bradyarrhythmia has not been documented. (Level of Evidence: C)}}

Guideline Resources

 * The ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities