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.

ablation, atrial tachycardia, heart transplantation, remnant atrium origin
dx.doi.org/10.1016/j.healun.2010.01.003, hdl.handle.net/1765/28302
The Journal of Heart and Lung Transplantation
Erasmus MC: University Medical Center Rotterdam

Bauernfeind, T, Caliskan, K.C, Kardos, A, Balk, A.H.M.M, Jordaens, L.J.L.M, & Szili-Török, T. (2010). Double intra-atrial connections in a patient late after orthotopic heart transplantation. The Journal of Heart and Lung Transplantation, 29(6), 700–703. doi:10.1016/j.healun.2010.01.003