Permanent pacing for asystole of the donor heart after heterotopic heart transplantation.

A 41-year-old woman presented with shortness of breath and decreased exercise tolerance 1 year after heterotopic heart transplantation. She was found to have an ejection fraction of less than 20% for the native heart and severely depressed left ventricular systolic function of the donor heart. A left ventriculogram of the donor heart showed no systolic contractility. A permanent pacemaker was implanted into the right ventricle of the donor heart. One year after pacemaker insertion, systolic function of the donor heart had returned to normal.