Permanent pacemaker implantation is required in a large number of tran
splantation patients principally because of sinus node dysfunction of
the donor atrium. The most suitable mode of pacing in these cases is s
till subject to controversy. We describe one case of a single lead sys
tem of VDD stimulation and sensing of the recipient atrial signal in a
32-year-old patient with posttransplant symptomatic sinus node dysfun
ction, Physiological adaptation of rate was achieved with recovery of
normal receptor sinus node function.