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Normal AV Node Function in Patients with Sinus Node Dysfunction After Cardiac Transplantation
Author(s) -
Heinz Gottfried,
Kratochwill Christoph,
Hirschl Michael,
Buxbaum Peter,
Kreiner Gerhard,
Gasic Slobodan,
Gossinger Heinz,
Laczkovics Axel
Publication year - 1993
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1993.tb00386.x
Subject(s) - medicine , node (physics) , sinus (botany) , transplantation , cardiology , cardiac dysfunction , cardiac function curve , heart failure , botany , genus , biology , structural engineering , engineering
A bstract Postoperative atrioventricular nodal (AVN) function was compared in 55 patients with normal and 50 patients with impaired sinus node (SN) function after cardiac transplantation (corrected SN recovery time > 520 msec or sinus arrest ± escape rhythm). Fifty‐two patients had fixed atrial pacing at cycle lengths between 600 and 430 msec, and 53 patients at cycle lengths from 600 to 300 msec between postoperative weeks 1 to 3. Relative (stimulus‐R interval; AVNRRP) and effective AVN refractory period (AVNERP) were determined in 53 patients at a cycle length of 500 msec. Only one of 105 recipients had high degree AVN conduction disturbance characterized by a Wenckebach phenomenon at cycle length < 630 msec in the first postoperative week. Three patients with normal and two patients with impaired SN function had Wenckebach cycle lengths > 430 msec while the Wenckebach cycle lengths were < 430 msec in the remainder (p = NS). Resting PQ interval (146 ± 18 vs 162 ± 32; p = 0.09), Wenckebach cycle length (350 ± 53 vs 362 ± 50 msec), AVNRRP (356 ± 38 vs 367 ± 37 msec), and AVNERP (217 ± 48 vs 244 ± 49 msec) did not differ significantly between patients with normal and impaired SN function. AVN conduction did not deteriorate during 318 ± 130 days of follow‐up (PQ at follow‐up 154 ± 17 and 158 ± 22 msec, patients with normal and impaired SN function, respectively). One DDD pacemaker was placed for AVN conduction disturbance while 22 pacemakers were implanted for SN deficiency. In conclusion, AVN conduction is usually unimpaired in patients with SN dysfunction after cardiac transplantation. These patients are good candidates for single chamber atrial pacing.