Cardiac resynchronization therapy after atrioventricular node ablation for rapid atrial fibrillation in a heart transplant recipient with late allograft dysfunction

Super-response to cardiac resynchronization therapy in orthotopic heart transplant with atypical right bundle branch block and cardiac allograft vasculopathy

“…Apor and colleagues 2 first described a patient with CAV, heart failure, depressed EF, and left bundle branch block (LBBB) 5 years after transplant treated with CRT placement. 2 In 2010, Mariani and colleagues 3 reported a patient with heart failure secondary to severe CAV with depressed EF, persistent atrial tachyarrhythmia requiring atrioventricular junction ablation, and subsequent dual-chamber ICD. Further worsening of LV function and heart failure prompted an upgrade to CRT 1 week later.…”

“…Further worsening of LV function and heart failure prompted an upgrade to CRT 1 week later. 3 Finally, in 2013 Vural and colleagues 4 described a patient 5 years removed from transplant with new CAV that developed systolic heart failure, a depressed EF, and Mobitz II atrioventricular block who was implanted with CRT. In all 3 cases, CRT resulted in moderate improvement in ventricular function and heart failure symptoms, as one might now reasonably expect, given the different indications in the contemporary guidelines that would respectively apply to each of these patients: EF <35%/class II-III NYHA CHF/LBBB >150 ms on GDMT (class I ACC/AHA/ESC), atrioventricular block with EF <35% and expectation of RV-based pacing >40% (class IIa ACC/AHA/ESC), and following atrioventricular junction ablation EF <35% on GDMT (class IIa ACC/AHA, class I ESC).…”

Anaesthesia Management for Ablation Therapy in Post Heart Transplant Arrhythmia

“…Radiofrequency ablation applies high-frequency, low-voltage electrical energy to the endocardium via a catheter-based electrode that leads to resistive thermal injury and subsequent coagulative necrosis of the tissue, thereby blocking reentrant electrical circuits causing atrial fibrillation [4]. Other reports have focused on the mechanism for atrial flutter post heart transplantation and potential therapy from cardiology perspective [5,6]. In this report we will focus on Anaesthesia management for ablation therapy in post heart transplant arrhythmia.…”