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Double intra-atrial connections in a patient late after orthotopic heart transplantation
Tamas Bauernfeind1, Kadir Caliskan, Attila Kardos
1Department of Clinical Electrophysiology, Thoraxcenter Erasmus MC, Rotterdam, The Netherlands.
Atrial tachycardias occurring late after orthotopic heart transplantation are frequently caused by an ongoing atrial tachycardia in the recipient remnant atrium that is associated with intra-atrial muscle band connections between the 2 atrial compartments. The standard approach for most centers that treat these patients is to identify and disconnect these intra-atrial connections. We present a patient where double intra-atrial connections were capable of different degrees of stimulus propagation from the recipient remnant atrium to the donor atrial compartment. After the ablation of both intra-atrial connections, we also ablated the index arrhythmia in the recipient remnant atrium. This case presentation draws attention to the possibility of the presence of multiple intra-atrial connections.
Atrial tachycardias occurring late after orthotopic heart transplantation are frequently caused by an ongoing atrial tachycardia in the recipient remnant atrium that is associated with intra-atrial muscle band connections between the 2 atrial compartments. The standard approach for most centers that treat these patients is to identify and disconnect these intra-atrial connections. We present a patient where double intra-atrial connections were capable of different degrees of stimulus propagation from the recipient remnant atrium to the donor atrial compartment. After the ablation of both intra-atrial connections, we also ablated the index arrhythmia in the recipient remnant atrium. This case presentation draws attention to the possibility of the presence of multiple intra-atrial connections.
