Case report: radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia in a patient with heart transplantation.

Ten years after orthotopic cardiac transplantation, a 56-year-old man developed recurrent presyncope and syncope. A 24-hour ambulatory electrocardiographic recording did not document significant arrhythmic events. A head-up tilt table test was negative. An electrophysiologic study revealed dual atrioventricular (AV) nodal physiology and inducible typical atrioventricular nodal reentrant tachycardia (AVNRT). The patient became hypotensive and presyncopal during AVNRT. Radiofrequency (RF) catheter ablation successfully eliminated AVNRT without complications. The patient remained free of symptoms at nine months follow-up.