Publish in this journal
Journal Information
Vol. 67. Issue 8.
Pages 668 (August 2014)
Image in cardiology
DOI: 10.1016/j.rec.2013.10.027
Full text access
Paroxysmal Supraventricular Tachycardia Immediately Following Heart Transplantation
Taquicardia supraventricular paroxística inmediatamente tras un trasplante cardiaco
Visits
...
Angel L. Miraclea, Felipe Atienzab,
Corresponding author
fatienzaf@secardiologia.es

Corresponding author:
, Francisco Fernández-Avilésb
a Servicio de Cardiología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
b Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

An electrophysiologic study was performed in a heart transplant recipient with recurrent episodes of paroxysmal supraventricular tachycardia that started shortly after surgery. Electrocardiograms at baseline and during tachycardia (A), as well as the adenosine response (B), are shown in Figure 1. Note culmination with 2 blocked P waves with different morphology and a frequency lower than that of the tachycardia.

Figure 1
(0.4MB).

Figure 2A depicts the catheter positions in left and right oblique views: a duodecapolar catheter was placed in an anteroposterior position, with the distal dipoles near the tricuspid annulus and the proximal dipoles toward the posteroseptal atrium, a tetrapolar catheter was placed in the right ventricle apex, and another ablation catheter was positioned in the coronary sinus. During tachycardia, a 1:1 atrioventricular conduction ratio (arrows) was seen in the distal duodecapolar dipoles (1-2) and in ablation, whereas dissociated atrial activity (asterisks) was seen in the proximal duodecapolar dipoles (13-14). The diagnostic maneuvers confirmed orthodromic tachycardia mediated by a right posteroseptal accessory pathway, requiring ablation in the coronary sinus ostium (ablation catheter, Figure 2B).

Figure 2
(0.19MB).

The dissociated atrial activity observed in the intracardiac recordings and surface electrocardiogram, indicated by asterisks in Figures 1 and 2, corresponded to the sinus rhythm of the remnant recipient atrium (transplantation had been performed using the biatrial technique), whereas the arrows indicate the atrial activity of the donor heart. This case illustrates orthodromic tachycardia in a transplanted heart, a situation only sporadically described in the literature, with a singular manifestation on electrocardiography due to the surgical technique used.

Copyright © 2013. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.