SINUS NODE DYSFUNCTION AFTER CARDIAC TRAN SPLANTATION

Sinus node function was studied in immediate and remote posttransplant ation periods after 56 single stage cardiac transplantations performed in the Institute of Transplantology and Artificial Organs between 198 6 and 1992. Five variants of sinus node function were found: 1) normal function (71, 1%); 2) concealed sinus node disfunction (SND) (1, 8%); 3) transitory SND (12, 5%); 4) persistent SND; 5) complete arrest of sinus node (8, 6%). In transitory SND duration of temporary pacing was 10, 6+/-1, 3 days while in persistent SND it was 31, 7+/-4, 1 days. P ermanent pacemaker implantation was required in 6 patients with persis tent SND or complete sinus node arrest in whom chronotropic drugs appe ared ineffective by clinical, ECG and electrophysiologic criteria. In 2 patients implantations were ''early'' (within 30 days post transplan tation) and in 4 - ''late'' (between 2nd and 21st months post transpla ntation). Whether pacemaker use in patients with SND prolongs life aft er cardiac transplantation is not clear yet. At present duration of su rvival is mainly determined by the degree of acute rejection and later by graft arteriopathy.