Donor-heart cardiectomy with subsequent orthotopic transplantation results in both, afferent and efferent cardiac denervation.The absence of vagally mediated influences thus leads to a resting heart rate (HR) above normal.Betablockers are widely used medication for heart transplant recipients (HTxR) with permanent sinus tachycardia (PST).Despite the demonstrated safety and efficacy, the use of betablockers can be limited by their side effects in addition to their adverse effects on lipid and carbohydrate metabolism.