title: Recognition and management of complex rhythm disorders in heterotopic heart transplantation.
abstract: Managing arrhythmias is challenging in patients who have undergone heterotopic heart transplantation because of the superimposed rhythms of the native and donor hearts. We present the case of a 43-year-old man with a previously placed biventricular pacemaker who underwent heterotopic heart transplantation and later developed acute rejection of the donor heart, which led to bradycardia and pause-dependent ventricular fibrillation. The patient remained clinically stable in the short term, likely because of partial recovery of myocardial function in the native heart. He later underwent placement of a pacing lead in the donor heart, allowing linking of the two hearts via a biventricular pacemaker.
authors.affiliation: Department of Transplant Research, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Frank
authors.forename: Mehdi
authors.initials: M
authors.lastname: Razavi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Saeed
authors.forename: Roberta C
authors.initials: RC
authors.lastname: Bogaev
authors.forename: Ali
authors.initials: A
authors.lastname: Massumi
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016042:Transplantation, Heterotopic / Q000009:adverse effects*; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology*