{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T18:47:40Z","timestamp":1782067660209,"version":"3.54.5"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Permanent pacemaker (PPM) implantation after heart transplantation (HT) is common, but contemporary data regarding utilization, outcomes, and emerging pacing technologies are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We studied PPM placement among 1225 bicaval HT recipients (28% women) treated at our institution from 2010 to 2025 and compared PPM recipients with HT patients without PPMs matched on sex, age, and transplant year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Median age at HT was 58 years (interquartile range, 48\u201365 years). Sixty-six (5%) patients received a PPM, with stable implantation rates over time. Median HT-to-PPM time was 4.3 months (interquartile range, 2 weeks to 4.8 years). The main indications were sinus node dysfunction (41 patients, 62%) or atrioventricular block (19 patients, 29%). Median post-HT survival was similar between PPM and non-PPM recipients (12.8 versus 11.5 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.14). Older organ donor age independently predicted PPM placement (odds ratio, 1.75;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.04). After 3.2 years of median follow-up, 1 transvenous PPM had a major complication requiring device extraction. Thirteen (20%) patients received leadless PPMs, including 3 atrial leadless PPMs and 1 dual-chamber leadless PPM. Leadless PPMs had no short-term complications over 1 year of median follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Post-HT PPM implantation rates were low and unchanged since 2010. Most devices were implanted for sinus node dysfunction, with 44% implanted within 1 month post-HT. PPM placement was not associated with post-HT survival. Advanced organ donor age was associated with risk of PPM placement. Transvenous PPM complication rates were comparable to rates described in general populations. Leadless PPMs accounted for a substantial minority of PPM placements since their introduction in 2018, with no complications to date. Longer follow-up is needed to establish their long-term outcomes and safety in patients with HT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.125.014442","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:00:20Z","timestamp":1779267620000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Utilization and Outcomes of Permanent Pacemakers After Bicaval Heart Transplantation: A Large Institutional Experience"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-8481","authenticated-orcid":true,"given":"John P.","family":"Sheppard","sequence":"first","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1068-8586","authenticated-orcid":true,"given":"Abdul K.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-2412","authenticated-orcid":true,"given":"Evan P.","family":"Kransdorf","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-2691","authenticated-orcid":true,"given":"Michelle M.","family":"Kittleson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon A.","family":"Kobashigawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Ramireddy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0097-0026","authenticated-orcid":true,"given":"Ashkan","family":"Ehdaie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunzhang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Shehata","sequence":"additional","affiliation":[{"name":"Department of Cardiology, 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