Multiple Interatrial Electrical Connection after Heart Transplantation


  • There are no potential conflicts of interest to declare.

Address for reprints: Pablo Peñafiel-Verdú, M.D., C/Dr. Ricardo Robles, 2,2°J., 30110 Murcia, Spain. Fax: 34968883036; e-mail:


A 62-year-old woman who underwent heart transplantation 6 years later presented a regular atrial tachycardia. Electrophysiologic evaluation showed an atrial arrhythmia in the recipient atrium with 2:1 conduction to the donor atrium, with a confusing electroanatomical map. With the suspect of alternant conduction through two different breakthroughs, the map was split in two concordant maps, corresponding to two connections that were successfully ablated. Later on, a third connection was detected and therefore ablated. (PACE 2011; 1–3)