ECG Following Cardiac Transplant

• Suturing of donor atria to the corresponding structures of a recipient’s residual atria produces two sets of P-waves:
  • A small native P-wave (often so small it may not been visualized)
  • Followed by a donor P-wave of normal size associated w/ a QRS complex
• A complete or incomplete right bundle branch develops in >80% transplant recipients
• ~7–25% of recipients also demonstrate a left anterior fascicular block (LAFB)
• The transplanted heart contracts faster than the atrial remnant secondary to autonomic denervation frequently resulting in an increased resting heart rate 

 

References

Chou's Electrocardiography in Clinical Practice: Adult and Pediatric 6^th Edition 

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