Although most patients with familial amyloid polyneuropathy (FAP) who undergo liver transplant will require a pacemaker, implanting the device before the transplant is not beneficial, according to a new study. The research, "Pacemaker implantation in familial amyloid polyneuropathy: when and for whom?external link, opens in a new tab," was published in the Journal of Interventional Cardiac Electrophysiology.
Cardiac manifestations in patients with FAP are due to dysautonomia - malfunction of the autonomic nervous system and deposits of the amyloid protein. Because these complications may persist after a liver transplant, which is the standard treatment for symptomatic FAP patients, implanting a pacemaker is important to prevent syncope (loss of consciousness usually due to insufficient blood flow to the brain) and sudden cardiac death.