Pre-operative anti-arrhythmic medication of cardiac transplant recipients is without impact on sinus rhythm after heart transplantation

Objectives: Anti-arrhythmic medication regulates cardiac rhythm. We examined this preoperative influence on cardiac transplant recipients in the postoperative course after heart transplantation (HTx).

Methods: We investigated 150 consecutive patients who underwent HTx in our institution between 1998 and 2000.

Results: The preoperative cardiac rhythm showed sinus rhythm (n=75), sinus tachycardia (n=11), atrial fibrillation (n=50), pace maker stimulation (n=14). The substances administered preoperatively were digitalis (n=116), β-blocker (n=57), amiodarone (n=48), magnesium (n=13), sotalol (n=3), verapamil (n=2), propafenon (n=2). Postoperatively amiodarone (n=14), digoxine (n=12), and lidocaine (n=13) were given.

Table: Number of patients (n) receiving preoperative anti-arrhythmic medication, their postoperative cardiac rhythm and number with good cardiac graft function (GOOD) or cardiac graft failure (FAILURE).

Post-OP cardiac rhythm/function/pre-OP medication	Sinus rhythm	AV blocking	Supraventricular arrhythmia	Supraventricular arrhythmia + AVblock	Asystole	Ventricular arrhythmia
n	43	29	28	11	8	31
GOOD	100%	86%	93%	100%	50%	13%
FAILURE	0%	14%	7%	0%	50%	87%
48 pts on amiodarone	25%	25%	16%	3%	4%	27%
102 pts w/o amiodarone	28%	19%	20%	9%	4%	19%
57 pts on β-blocker	27%	19%	25%	8%	4%	17%
93 pts w/o β-blocker	27%	22%	15%	7%	5%	24%
116 pts on digitalis	27%	19%	21%	7%	5%	22%
34 pts w/o digitalis	26%	29%	13%	10%	3%	19%

Conclusions: Medication for anti-arrhythmic purposes in patients waiting for HTx is without influence on the occurrence or continuation of sinus rhythm after HTx. No preoperatively administered substance was associated with postoperative arrhythmia or with cardiac graft failure.