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 6th Edition
