Key result
Donor heart accessory pathways cause ~4% of post-transplant supraventricular tachycardias.
Why the study?
Supraventricular tachycardia after orthotopic heart transplantation is uncommon, and atrioventricular reentrant tachycardia from an accessory pathway in the donor heart is a particularly rare mechanism accounting for approximately 4% of post-transplant SVTs.
Case Report
This case report highlights a rare mechanism of supraventricular tachycardia after orthotopic heart transplantation: atrioventricular reentrant tachycardia (Wolf Parkinson White syndrome) caused by an accessory pathway in the donor heart.
Donor accessory pathways can mediate AVRT after OHT; extends the SVT differential and supports EP evaluation in refractory transplant cases.
Orthotopic heart transplantation (OHT) remains the most effective long-term therapy for end-stage heart disease, and the number of transplants performed annually continues to rise.1 Supraventricular tachycardia (SVT) after OHT is uncommon and typically arises in the setting of incisional scar or postoperative sequelae such as graft ischemia or graft dysfunction.2 One particularly rare mechanism of SVT is atrioventricular reentrant tachycardia (AVRT) resulting from an accessory pathway in the donor heart, which is estimated to account for approximately 4% of all SVTs following OHT.
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Villarreal et al. (2026) conducted a case report in Wolff-Parkinson-White syndrome after orthotopic heart transplantation. Orthotopic heart transplantation was evaluated. Accessory pathways in the donor heart causing atrioventricular reentrant tachycardia account for approximately 4% of all supraventricular tachycardias following orthotopic heart transplantation.
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