High-grade atrioventricular block requiring pacemaker implantation after cardiac transplantation: An unusual complication

Self-limited bradyarrhythmias are commonly seen in postorthotopic heart transplantation patients. The most common cause of such bradyarrhythmias is sinus node dysfunction. Atrioventricular (AV) nodal blocks requiring pacemaker implantation remain distinctly uncommon. After ruling out reversible causes including dyselectrolytemia and drug toxicity, prolonged ischemia time of donor heart and transplant rejection should be considered as possible causes. The present case describes an uncommon occurrence of persistent high-grade AV block in postheart transplantation period ultimately requiring permanent pacemaker implantation.