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Ablation of premature ventricular contractions in a transplanted human heart suffering from graft vasculopathy

  • Leonard Bergau
  • Mustapha El-Hamriti
  • Philipp Sommer
  • Christian SohnsEmail author
Letter to the Editors
  • 64 Downloads

Sirs,

This case report demonstrates that ablation of premature ventricular contractions (PVCs) arising from the papillary muscle can be performed safe and effective in a patient suffering from graft vasculopathy transferring ablation strategies from native hearts. A 66-year-old male patient was referred to our hospital due to frequent PVCs with > 20,000 PVCs in 24-h Holter monitoring (PVC burden 25%). The patient received an orthotopic heart transplant at our center due to dilated cardiomyopathy (DCM) in 1992. Following a relatively long observational period without any serious complications, three-vessel graft vasculopathy with chronic occlusion of the right coronary artery (RCA) was diagnosed in 2008. In 2015, a significant stenosis of the circumflex artery (RCx) was revascularized by percutaneous transluminal coronary angioplasty (PTCA). Afterwards, no progression of the graft vasculopathy was found. Furthermore, myocardial biopsies found no evidence for a progressive graft-vs-host...

Notes

Compliance with ethical standard

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Vaseghi M, Boyle NG, Kedia R, Patel JK, Cesario DA, Wiener I, Kobashigawa JA, Shivkumar K (2008) Supraventricular tachycardia after orthotopic transplantation. J Am Coll Cardiol 51:2241–2249.  https://doi.org/10.1016/j.jacc.2008.02.065 CrossRefGoogle Scholar
  2. 2.
    Rivinius R, Helmschrott M, Ruhparwar A, Erbel C, Gleissner CA, Darche FF, Thomas D, Bruckner T, Katus HA, Doesch AO (2017) The influence of surgical technique on early posttransplant atrial fibrillation- comparison of biatrial, bicaval, and total orthotopic heart transplantation. Ther Clin Risk Manag 13:287–297.  https://doi.org/10.2147/TCRM.S126869 CrossRefGoogle Scholar
  3. 3.
    Nof E, Stevenson WG, Epstein LM, Tedrow UB, Koplan BA (2013) Catheter ablation of atrial arrhythmias after cardiac transplantation: findings at EP study utility of 3-D mapping and outcomes. J Cardiovasc Electrophysiol 24:498–502.  https://doi.org/10.1111/jce.12078 CrossRefGoogle Scholar
  4. 4.
    Bogun F, Desjardins B, Crawford T, Good E, Jongnarangsin K, Oral H, Chugh A, Pelosi F, Morady F (2008) Post-infarction ventricular arrhythmias originating in papillary muscles. J Am Coll Cardiol 51:1794–1802.  https://doi.org/10.1016/j.jacc.2008.01.046 CrossRefGoogle Scholar
  5. 5.
    Thajudeen A, Stecker EC, Shehata M, Patel J, Wang X, McAnulty JH Jr, Kobashigawa J, Chugh SS (2012) Arrhythmias after heart transplantation: Mechanisms and Management. J Am Heart Assoc 1:e001461.  https://doi.org/10.1161/JAHA.112.001461 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Clinic for Electrophysiology, Herz- und Diabeteszentrum Nordrhein-WestfalenRuhr-Universität BochumBad OeynhausenGermany

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