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European Heart Journal 1993 14(4):530-533;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Heart rate and late mortality in cardiac transplant recipients

C. D. SCOTT, J. M. McCOMB and J. H. DARK

Cardiothoracic Centre, Freeman Hospital Freeman Road, Newcastle upon Tyne NE7 7DN, U.K.

Received 11 March 1991; .

Correspondence: Dr C D. Scott, Cardiothoracic Centre, Freeman Hospital, Freeman Road, Newcastle upon Tyne NE7 7DN, U.K.

Abstract

There are currently 104 patients at this centre who have survived at least 3 months after orthotopic cardiac transplantation. Seven of these long-term survivors have subsequently died and in three cases death was sudden and unexpected. All three of these patients had been noted to have inappropriately high resting heart rates (>130 b.min–1) The rhythm was sinus tachycardia, supraventricular tachycardia or both intermittently.

The heart rates of all 104 long-term survivors were recorded from ECGs taken at routine follow-up visits every 3 months for one year and annually thereafter. The overall mean heart rate was 100±13.2 b.min–1.

Four patients, including the three identified above, had mean heart rates greater than the 95th centile. The mortality rate in this group is 75%. Four deaths have occurred in the remaining 100 patients (P <0.001).

In our series, an inappropriately high resting heart rate due to sinus tachycardia or supraventricular tachycardia in long-term survivors of cardiac transplantation, is an adverse prognostic sign.

Key Words: Heart transplantation • arrhythmia • sudden death


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