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

We report the successful use of cardiac resynchronization therapy in an orthotopic heart transplant recipient with late graft dysfunction, severe heart failure, and atrial fibrillation requiring atrioventricular node ablation. This case highlights the potential role for cardiac resynchronization therapy in orthotopic heart transplant recipients with systolic dysfunction and heart failure, especially in the setting of forced right ventricular pacing. Despite potentially different mechanisms of left ventricular dysfunction, biventricular pacing should be considered for allograft recipients with conventional indications for cardiac resynchronization therapy.

Keywords: cardiac resynchronization therapy, allograft dysfunction, cardiac allograft vasculopathy, AV node ablation, pacing, biventricular pacing, heart failure