Two hearts beating as one: radiofrequency ablation of the His bundle in a heterotopic heart transplant patient.

We describe a 54-year-old man with heterotopic heart transplantation, who had severe exertional angina and dyspnea related to native heart ischemic disease. Because of drug resistant atrial fibrillation and atrial flutter of the native heart with fast ventricular response (130 beats/min), right-sided radiofrequency ablation of the His bundle was undertaken, followed by permanent pacemaker linkage of donor and native hearts. The procedure was successful and uneventful. Remarkable relief of symptoms was achieved.