{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T17:55:08Z","timestamp":1765216508544,"version":"3.46.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complete atrioventricular (AV) block is a rare complication immediately following orthotopic heart transplantation (OHT), typically attributed to ischaemic injury or surgical trauma. In immunosuppressed patients, pacemaker selection requires careful consideration due to heightened infection risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present a 48-year-old woman with hypertrophic cardiomyopathy who developed persistent complete AV block with no ventricular escape following OHT. The early postoperative period was complicated by right ventricular failure and severe systemic infections. After stabilization, on Day 32 post-transplant, a Micra AV2 leadless pacemaker was implanted due to high infectious risk and presence of moderate-to-severe tricuspid regurgitation. The procedure was successful, with no complications and adequate AV synchrony after optimization. The patient remained clinically stable, with no pacemaker-related complications or rejection on biopsy, and was discharged on Day 45.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first reported case of Micra AV2 implantation in a transplant recipient. Leadless AV-synchronous pacemakers may be an ideal option in select patients early post-transplant, especially those at high risk for infection and with tricuspid valve dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf606","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T13:28:22Z","timestamp":1763731702000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiac transplant-associated complete AV block treated with a leadless pacemaker: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2722-3327","authenticated-orcid":false,"given":"D\u00e9bora","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Central do Funchal , Avenida Lu\u00eds de Cam\u00f5es no 57, Funchal, Madeira 9004-514 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo","family":"Cavaco","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Cruz, Unidade Local de Sa\u00fade Lisboa Ocidental , Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Lisboa 2790-134 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6894-648X","authenticated-orcid":false,"given":"Daniel","family":"Gomes","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Cruz, Unidade Local de Sa\u00fade Lisboa Ocidental , Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Lisboa 2790-134 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Br\u00edzido","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Cruz, Unidade Local de Sa\u00fade Lisboa Ocidental , Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Lisboa 2790-134 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3729-3137","authenticated-orcid":false,"given":"Pedro","family":"Adrag\u00e3o","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Cruz, Unidade Local de Sa\u00fade Lisboa Ocidental , Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Lisboa 2790-134 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"2025120812520400300_ytaf606-B1","first-page":"20","article-title":"Pacemaker use following heart transplantation","volume":"17","author":"Mallidi","year":"2017","journal-title":"Ochsner J"},{"key":"2025120812520400300_ytaf606-B2","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.hrthm.2010.06.026","article-title":"Long-term outcomes and clinical predictors for pacemaker-requiring bradyarrhythmias after cardiac transplantation: analysis of the UNOS\/OPTN cardiac transplant database","volume":"7","author":"Cantillon","year":"2010","journal-title":"Heart Rhythm"},{"key":"2025120812520400300_ytaf606-B3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/01.TP.0000071933.14397.43","article-title":"Cause of atrioventricular block in patients after heart transplantation","volume":"76","author":"Cui","year":"2003","journal-title":"Transplantation"},{"key":"2025120812520400300_ytaf606-B4","doi-asserted-by":"crossref","first-page":"e007954","DOI":"10.1161\/CIRCEP.120.007954","article-title":"Management of arrhythmias after heart transplant: current state and considerations for future research","volume":"14","author":"Joglar","year":"2021","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2025120812520400300_ytaf606-B5","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jacep.2019.10.017","article-title":"Atrioventricular synchronous pacing using a leadless ventricular pacemaker: results from the MARVEL 2 study","volume":"6","author":"Steinwender","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2025120812520400300_ytaf606-B6","doi-asserted-by":"crossref","first-page":"euae060","DOI":"10.1093\/europace\/euae060","article-title":"Strategies to improve atrioventricular synchrony in patients with a Micra AV leadless pacemaker","volume":"26","author":"Garweg","year":"2024","journal-title":"Europace"},{"key":"2025120812520400300_ytaf606-B7","first-page":"2214","article-title":"Utilization of leadless pacemaker following orthotopic heart transplantation for complete heart block during index hospitalization","volume":"10","author":"Gopalan","year":"2024","journal-title":"HeartRhythm Case Rep"},{"key":"2025120812520400300_ytaf606-B8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jelectrocard.2020.03.010","article-title":"Leadless pacing in cardiac transplant recipients: primary results of a multicenter case experience","volume":"60","author":"Rordorf","year":"2020","journal-title":"J Electrocardiol"},{"key":"2025120812520400300_ytaf606-B9","doi-asserted-by":"crossref","first-page":"1225833","DOI":"10.3389\/fcvm.2023.1225833","article-title":"Incidence of atrioventricular block after isolated coronary artery bypass grafting: a systematic review and pooled-analysis","volume":"10","author":"Yaghoobian","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"2025120812520400300_ytaf606-B10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.hrthm.2022.08.033","article-title":"Ambulatory atrioventricular synchronous pacing over time using a leadless ventricular pacemaker: primary results from the AccelAV study","volume":"20","author":"Chinitz","year":"2023","journal-title":"Heart Rhythm"},{"key":"2025120812520400300_ytaf606-B11","doi-asserted-by":"crossref","first-page":"e256054","DOI":"10.1136\/bcr-2023-256054","article-title":"Leadless pacemaker in heart transplantation: a case report and literature review","volume":"16","author":"Yan","year":"2023","journal-title":"BMJ Case Rep"}],"container-title":["European Heart Journal - 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