Radiofrequency Ablation of a Supra ventricular Tachycardia Due to Interatrial Conduction From the Recipient to Donor Atria in an Orthotopic Heart Transplant Recipient

Abstract

Interatrial conduction of recipient atrial tachycardia to the donor atria of an orthotopic heart transplant recipient resulted in a unique cause of supraventricular tachycardia. An electrophysiologic study was performed, and the recipient atria was found to be in an atrial tachycardia, cycle length of 210 msec, with periods of both 2:1 and 1:1 conduction to the donor atria resulting in a donor atrial cycle length of 420 msec and 210 msec, respectively. The site of interatrial conduction was mapped to the right atrial suture line, along the atrial free wall, and was successfully disrupted with radiofrequency energy. Arrhythmias of a similar mechanism may also be observed in other postsurgical patients.