An unusual story of electrical storm on the graft.

Etienne Charbonneau¹^, ², MD, Céline Chabanne¹^, ², MD, Bernard Lelong¹^,², MD, Vincent Galand ², MD, Erwan Flécher¹, MD, PhD.

¹Department of cardiothoracic and vascular surgery, Rennes University Hospital, Rennes, France

²Department of cardiology, Rennes University Hospital, Rennes, France.

The data that support the findings of this study are openly available in Journal of Cardiac Surgery at http://doi.org/[doi], reference number [reference number].

Corresponding Author:

Dr Etienne Charbonneau

Departement of Cardiology

CHU Pontchaillou

2 henri Le Guilloux St

35 000 Rennes, France

Tel : +33648883662

Email : echarbonneau@hotmail.fr

Declarations of interest: none

Funding : none

AbstractBackground: Cancers, and specifically lymphomas, are one of the main causes of morbidity and mortality after heart transplant. We encountered this complication on a 54-year-old male patient, which brought to our attention the lack of a specific and appropriate treatment for a primary cardiac lymphoma on the graft.

Objective: This case report highlights the challenging management of primitive heart transplant lymphoma and its treatment.

Method: electronic medical record literature reviewed through Pubmed interface of Medline.

This study was approved by the CHU Rennes Ethics Committee.

Written informed consent was obtained from the patient for the publication of this case report.

Result: We report the case of an Epstein-Barr Virus (EBV) induced primary cardiac lymphoma on the graft. The lymphoma spread quickly in spite of the numerous treatments we tried and resulted in rhythmic complication. Endocavitary implantable cardioverter defibrillator was implanted but quickly removed due to local complications. The patient died from a sudden death at home shortly after.

Conclusions: Primary cardiac lymphoma on the graft is highly rare with poor prognosis and rhythmic complications. Further studies are needed to assess the benefits of other treatment approaches, such as radiofrequency ablation techniques.

Keywords: lymphoma, heart transplant, ventricular arythmia, electrical storm.

Abbreviations; ICD: implantable cardioverter defibrillator, EBV: ebstein bar virus, TV: ventricular tachycardia, CICU: Cardiac Intensive Care Unit.