Arritmias após transplante cardíaco ortotópico / Arrhythmias After Orthotopic Heart Transplantation

ABSTRACT

PURPOSE--To correlate the incidence of arrhythmias to the degree of allograft rejection on endomyocardial biopsy. METHODS--Seventeen patients who underwent orthotopic heart transplantation were submitted to ambulatory Holter monitoring 24h prior to endomyocardial biopsy. The biopsy results were compared to Holter monitoring results. RESULTS--The mean study period was 252 +/- 166 days (15 to 515). We found a high incidence of ventricular premature beats (> 70 per cent), except in patients with severe rejection (25 per cent), but there was no statistically significant difference between the groups with no rejection, mild and moderate rejection. Atrial premature beats were more common in patients with mild and moderate rejection (53 per cent and 70 per cent, respectively) when compared to patients with no rejection (33 per cent) and patients with severe rejection (9 per cent), (p < 0.05). Sinus bradycardia was present in 50 per cent of patients with severe rejection, but only in 9 per cent of moderate, 3 per cent of mild and 5 per cent of the patients with no rejection (p < 0.05). CONCLUSION--Supraventricular tachycardia and atrial premature beats are related to moderate rejection. Ventricular premature beats are not related to degree of rejection. Sinus bradycardia occurring in the first year after transplantation should suggest severe cardiac allograft rejection