emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2025.9.2.2659emcardio-328Research ArticleИнтересный клинический случайAn interesting clinical caseКлинический случай катетерной аблации типичного трепетания предсердий у пациентаA clinical case of catheter ablation of typical atrial flutter in a patient after orthotopic heart transplantationЧаснойтьА. Р.ChasnoitsA. R.

Минск

Minsk

achasnoits@yandex.ruЗавалейЕ. А.ZavaleyE. A.

Минск

Minsk

БарсукевичВ. Ч.BarsukevichV. C.

Минск

Minsk

ПлащинскаяЛ. И.PlashchinskayaL. I.

Минск

Minsk

ВерасЯ. А.VerasY. A.

Минск

Minsk

ГончарикД. Б.GoncharikD. B.

Минск

Minsk

ГУ «Республиканский научно-практический центр «Кардиология»Republican Scientific and Practical Center “Cardiology”2025250120269226592667Copyright © Часнойть А.Р., Завалей Е.А., Барсукевич В.Ч., Плащинская Л.И., Верас Я.А., Гончарик Д.Б., 20262026Часнойть А.Р., Завалей Е.А., Барсукевич В.Ч., Плащинская Л.И., Верас Я.А., Гончарик Д.Б.Chasnoits A.R., Zavaley E.A., Barsukevich V.C., Plashchinskaya L.I., Veras Y.A., Goncharik D.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/328

Ортотопическая трансплантация сердца является значимым достижением современной кардиохирургии для пациентов с терминальной стадией хронической сердечной недостаточности, где другие методы лечения становятся неэффективными. Одними из распространенных осложнений после ортотопической трансплантации сердца являются предсердные аритмии, которые могут существенно затруднить процесс восстановления после операции. Макрориентри аритмии представляют собой одну из самых распространенных форм предсердных аритмий у данной группы пациентов. Они обусловлены значительными изменениями геометрии предсердий, которые происходят в результате хирургического вмешательства. Чаще встречается типичное истмус-зависимое трепетание предсердий в донорском органе, но также встречаются и атипичные формы с распространением по линии швов либо в оставшейся части предсердий реципиента. В данной статье мы представили уникальный клинический случай, который иллюстрирует одновременное наличие у пациента типичного истмус-зависимого трепетания предсердий в донорском сердце и атипичного трепетания предсердий в остаточной ткани правого предсердия сердца реципиента. Мы также обсудили методы электрофизиологической диагностики данных нарушений ритма и успешное лечение методом катетерной аблации.

Orthotopic heart transplantation is a significant achievement of modern cardiosurgery for patients with terminal stage of chronic heart failure, where other treatment methods become ineffective. One of the common complications after orthotopic heart transplantation is atrial arrhythmias, which can significantly complicate the recovery process after surgery. Macro-reentry arrhythmias are one of the most common forms of atrial arrhythmias in this patient group. They are caused by significant changes in the geometry of the atria, which occur as a result of the surgical intervention. Typical isthmus-dependent atrial flutter is more common in the donor organ, but atypical forms with extension along the sutures or in the residual tissue of the recipient’s atria are also observed. In this article, we presented a unique clinical case that illustrates the simultaneous presence of typical isthmus-dependent atrial flutter in the donor heart and atypical atrial flutter in the residual tissue of the recipient’s right atrium. We also discussed the methods of electrophysiological diagnosis of these arrhythmias and the successful treatment using catheter ablation.

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The authors declare that there are no conflicts of interest present.