“…Thus, the pacemaker feels the P-wave of the native heart and, after an adjustable pause, stimulates the atrium of the transplanted heart, producing synchronized beats of both hearts, in the same logical sequence of the intraaortic balloon which is important in optimizing the cardiac output in the first postoperative days [6][7][8] . After discharge from the ICU and the removal of epicardial wires of the pacemaker, there was no more electrical synchronization between the two hearts; however, a spontaneous tendency to an equalization of the heart beats occurred, which could be attributed to the lower adrenergic stimulation provided by an improved cardiac output, due to the implanted heart.…”