An Unusual Atrial Tachycardia in a Cardiac Transplant Patient.

A 74-year-old woman with prior history of ischemic cardiomyopathy underwent heart transplant with bi-atrial anastomosis in 1992. She was diagnosed with a supraventricular tachycardia (SVT) in 1995, prompting initiation of flecainide. She later developed recurrent, symptomatic SVT despite drug titration. At electrophysiology study, programmed stimulation induced an atrial tachycardia with gaps in atrial activity. These gaps in atrial activation were approximately twice the atrial tachycardia cycle length (Fig. 1). This article is protected by copyright. All rights reserved.