Heart Transplantation in Frequently Recurrent Drug-Refractory Tachyarrhythmias: is it Worthwhile?

Despite the fact that many cardiac transplantation candidates manifest potentially worrisome rhythm disturbances, refractory life-threatening cardiac arrhythmias (specifically ventricular tachyarrhythmias) are rarely the primary indication for cardiac transplantation. As a result, available clinical experience with this potential transplant indication is small. Nevertheless, as methods for stabilizing hemodynamics in the sickest heart failure patients progress (e.g., left ventricular assist devices (LVADs), ACORN left ventricular (LV) stenting, intractable cardiac arrhythmias may increasingly play a role in transplantation decision making. This communication examines the current status of cardiac arrhythmias as an indication for heart transplantation.