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Radiofrequency ablation of an accessory pathway years after heart transplant: a case report
1University of Arizona College of Medicine, Tucson 85724, USA.
Insights
Heart transplant recipients can develop dormant accessory pathways, leading to tachycardia years later. Radiofrequency ablation successfully treated a patient with a long-standing pathway after orthotopic heart transplantation.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Transplantation Medicine
Background:
- Orthotopic heart transplantation is a life-saving procedure for end-stage heart failure.
- Accessory pathways can cause supraventricular tachycardia, posing risks to patients.
Observation:
- A patient, 9 years post-heart transplant, presented with a 3-hour episode of tachycardia.
- This was the patient's second documented episode of sustained tachycardia.
Findings:
- Electrophysiological study identified a left antero-lateral accessory pathway.
- Radiofrequency ablation effectively eliminated the accessory pathway.
Implications:
- Accessory pathways may remain clinically silent for extended periods after heart transplantation.
- This case highlights the importance of considering accessory pathways in heart transplant recipients presenting with arrhythmias.
- Long-term surveillance for arrhythmias in heart transplant patients is crucial.
Abstract:
A patient who had an orthotopic heart transplantation performed 9 years previously presented with a history of tachycardia lasting for three hours. He had only 1 previous episode of sustained tachycardia 4 years previously. Electrophysiological study showed a left antero-lateral accessory pathway which was successfully ablated using radiofrequency energy. This report indicates that some pathways may remain dormant for a long time after heart transplantation.