Alexopoulos D, Yusuf S, Bostock J, Johnston J A, Sleight P, Yacoub M H
Harefield Hospital, Middlesex.
Br Heart J. 1988 Jun;59(6):648-52. doi: 10.1136/hrt.59.6.648.
Fourteen long term survivors with orthotopic (recipient heart replaced by donor heart) and nine with heterotopic cardiac transplants (recipient heart retained) had 24 hour ambulatory electrocardiographic monitoring to detect ventricular arrhythmias. Arrhythmia was uncommon in the patients with orthotopic transplants; none of them had more than one extrasystole per hour. In the patients with heterotopic cardiac transplants the recipient's own heart showed significantly more frequent ventricular arrhythmias than the corresponding donor heart: abnormal complexes (mean/24 h) 4583 vs 42.7; extrasystoles 1772 vs 17.8; pairs 121 vs 0.8. There was no relation between the abnormal ventricular activity of the two hearts in the patients with heterotopic transplants on a beat by beat, hourly, or 24 hour basis. There was no consistent diurnal variation in the frequency of the abnormal ventricular beats after cardiac transplantation. The occurrence of ventricular arrhythmia was unrelated to the interval from operation to the study. In long term survivors of cardiac transplantation the denervated heart shows a little ventricular ectopic activity even when compared with normal hearts. In patients with heterotopic transplants ventricular arrhythmias commonly occur in the recipient's own heart; these are probably related to the underlying severity of the original disease.
14例原位心脏移植（受体心脏被供体心脏取代）的长期存活者和9例异位心脏移植（受体心脏保留）的长期存活者接受了24小时动态心电图监测以检测室性心律失常。在原位心脏移植患者中，心律失常并不常见；他们中每小时早搏均不超过1次。在异位心脏移植患者中，受体自身心脏显示出比相应供体心脏明显更频繁的室性心律失常：异常复合波（平均/24小时）4583对42.7；早搏1772对17.8；成对早搏121对0.8。在异位移植患者中，两颗心脏的异常心室活动在逐搏、每小时或24小时的基础上均无关联。心脏移植后异常心室搏动的频率没有一致的昼夜变化。室性心律失常的发生与手术至研究的间隔时间无关。在心脏移植的长期存活者中，去神经支配的心脏即使与正常心脏相比也显示出少量的心室异位活动。在异位移植患者中，室性心律失常通常发生在受体自身心脏；这些可能与原发病的潜在严重程度有关。
