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Preserved electrical conduction between donor and recipient right atria as the cause of macroreentrant atrial tachycardia after heart transplantation

Erhaltene elektrische Leitung zwischen den rechten Vorhöfen von Donor und Empfänger als Ursache einer Makroreentry-Vorhoftachykardie nach Herztransplantation


Atrial arrhythmias after heart transplantation are common and usually originate from reentrant circuits inside the donor and recipient atria. A case is presented of macroreentrant atrial tachycardia with a reentry circuit incorporating preserved electrical conduction from the donor and recipient right atria. An invasive electrophysiological study including high-density electroanatomical mapping with a multipolar catheter was performed during tachycardia. A reentry circuit with an area of slow conduction at the supero-lateral aspect of the surgical anastomosis could be demonstrated. Catheter ablation at the site of slow conduction successfully terminated and permanently suppressed the tachycardia.


Atriale Arrhythmien sind ein häufiges klinisches Problem nach Herztransplantation und entspringen gewöhnlich aus Reentry-Kreisläufen innerhalb der Donor- und Empfängervorhöfe. Im Folgenden wird der Fall einer Makroreentry-Vorhoftachykardie aufgrund eines Reentry-Kreislaufs mit bestehender elektrischer Leitung zwischen rechtem Donor- und Empfängervorhof vorgestellt. Eine invasive elektrophysiologische Untersuchung mit elektroanatomischem High-density-3-D-Mapping unter Verwendung eines multipolaren Katheters wurde während Tachykardie durchgeführt. So konnte ein Reentry-Kreislauf mit Einbeziehung einer „slow conduction area“ im superolateralen Bereich der chirurgischen Anastomose dargestellt werden. Die folgende Katheterablation in diesem Bereich konnte die Tachykardie erfolgreich terminieren und dauerhaft unterdrücken.

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Correspondence to Thomas Fink MD.

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Conflict of interest

T. Fink, V. Sciacca, L. Bergau, M. Khalaph, M. Braun, G. Imnadze, M. El Hamriti, P. Sommer, and C. Sohns declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. Additional written informed consent was obtained from all individual participants or their legal representatives for whom identifying information is included in this article.

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Fink, T., Sciacca, V., Bergau, L. et al. Preserved electrical conduction between donor and recipient right atria as the cause of macroreentrant atrial tachycardia after heart transplantation. Herzschr Elektrophys (2021).

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  • Heart transplantation
  • Atrial tachycardia
  • Reentry mechanism
  • 3D mapping
  • Catheter ablation


  • Herztransplantation
  • Atriale Tachykardie
  • Reentry-Mechanismus
  • 3‑D-Mapping
  • Katheterablation