Radiofrequency ablation of focal atrial tachycardia and atrioatrial conduction from recipient to donor after orthotopic heart transplantation

RF Ablation of Recipient-to-Donor Atrial Tachycardia, After cardiac transplantation, atrial arrhythmias may develop in the residual recipient atrium and conduct to the donor heart. Radiofrequency (RF) ablation of the atrioatrial conduction may be effective in arrhythmia control, although the recipient atrium continues its tachycardia, We hypothesize that in patients with posttransplant atrial tachycardia, it is possible to ablate both the arrhythmogenic focus in the recipient atrium and the atrioatrial conduction. A 47-year-old patient who had orthotopic heart transplantation 9 months earlier underwent RF ablation procedure because of medically uncontrolled atrial arrhythmia. By conventional electrophysiologic mapping, we localized the focus of the atrial tachycardia in the recipient atrium and the electrical atrioatrial connection across the anastomotic suture line. Selective applications of RF energy eliminated both targets successfully. RF ablation of recipient atrial tachycardia and atrioatrial conduction from recipient to donor may lead to long-term success of arrhythmia control.