Catheter ablation of atrial flutter after orthotopic heart transplantation.
BACKGROUND
Atrial arrhythmias, including atrial flutter, are common in orthotopic heart transplant recipients. However, only a small number of individual case reports describe the electrical circuit and catheter ablation of atrial flutter after heart transplantation.


RESULTS
Detailed electrophysiologic evaluation and radiofrequency ablation of atrial flutter were performed in three patients after orthotopic heart transplantation. All cases involved a counterclockwise flutter circuit around the tricuspid annulus. All were successfully ablated at the isthmus between the tricuspid valve and the atrial anastomosis adjacent to the inferior vena cava.


CONCLUSIONS
Atrial flutter involving a counterclockwise circuit around the tricuspid annulus is common in the heart transplant population. Based on the patients described in this study and other cases reported in the literature, this arrhythmia often is treated successfully by ablation of the isthmus between the tricuspid valve and the atrial anastomosis near the inferior vena cava.
Heist
E Kevin
EK
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Doshi
Shephal K
SK
Singh
Jagmeet P
JP
Di Salvo
Thomas
T
Semigran
Marc J
MJ
Reddy
Vivek Y
VY
Keane
David
D
Ruskin
Jeremy N
JN
Mansour
Moussa
M
D000328:Adult; D001282:Atrial Flutter / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome