Interventricular conduction disorders after orthotopic heart transplantation: risk factors and clinical relevance.
BACKGROUND
Causes and significance of interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) are still unknown.


METHODS
We retrospectively researched the presence of IVCDs in 240 patients who underwent bicaval OHT in three time periods: at day 1, after 1 year, and after 3 years from OHT. To evaluate the impact of the surgical technique, a control population treated with biatrial anastomosis was used.


RESULTS
The most common IVCD was right bundle branch block (RBBB). Its presence at day 1 correlated with transpulmonary gradient before OHT. Its presence after 1 year and its development correlated with a 1-month acute rejection score≥2 (p = .050 and p = .006). The incidence of RBBB was higher in the biatrial control population (40.7% vs 23.8%, p < .001).


CONCLUSIONS
RBBB is the most common IVCD. Its presence can be explained by a susceptibility of the right branch to heart positioning, pressure overload, and acute rejection. IVCDs do not affect prognosis.
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Sonia
S
Ferretto
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Elvin
E
Tafciu
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Immacolata
I
Giuliani
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Giuseppe
G
Feltrin
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Tomaso
T
Bottio
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Antonio
A
Gambino
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Angela
A
Fraiese
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Sabino
S
Iliceto
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Gino
G
Gerosa
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Loira
L
Leoni
D002037:Bundle-Branch Block / Q000175:diagnosis; D000075224:Cardiac Conduction System Disease / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors
clinical; clinical noninvasive techniques-electrocardiography; electrophysiology-conduction disturbances