Multiple Interatrial Electrical Connection after Heart Transplantation

Abstract

A 62-year-old woman who underwent heart transplantation 6 years later presented a regular atrial tachycardia. Electrophysiologic evaluation showed an atrial arrhythmia in the recipient atrium with 2:1 conduction to the donor atrium, with a confusing electroanatomical map. With the suspect of alternant conduction through two different breakthroughs, the map was split in two concordant maps, corresponding to two connections that were successfully ablated. Later on, a third connection was detected and therefore ablated.

Multiple atrial tachycardias after orthotopic heart transplantation: A case report and literature review

“… 2 Table 1 lists the single and serial cases of post-OHT AT ablations guided by 3-dimensional mapping system reported in the literature in the last decade. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 The majority of ATs in stable OHT patients can be attributed to macroreentrant tachycardia, including CTI-dependent flutter and scar-reentrant AT. 1 , 2 Focal AT can be observed originating in low-voltage or border zones adjacent to biatrial anastomosis suture lines.…”