Evidence map›Paper›PMID 42165468›Full record

ArticleJACC. Case reports2026

Ventricular Fibrillation Without Hemodynamic Deterioration: An Electrocardiographic Paradox Explained by Heterotopic Heart Transplantation.

Jasmin Zernikow, Isabella Hintz, Sebastian Spethmann, Jan Gröschel, Nikolaos Dagres, Felix Schoenrath, Gerhard Hindricks, Christoph Knosalla, Friedrich Koehler, Wilhelm Haverkamp

Abstract readCase Reports
In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jasmin ZernikowDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany.
Isabella HintzDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Sebastian SpethmannDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany.
Jan GröschelDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany.
Nikolaos DagresDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany.
Felix SchoenrathCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Gerhard HindricksDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany.
Christoph KnosallaCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Friedrich KoehlerCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany; Centre for Cardiovascular Telemedicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany. Electronic address: friedrich.koehler@dhzc-charite.de.
Wilhelm HaverkampDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeterotopic heart transplantation (HHT) is rarely performed in contemporary practice and poses distinct electrophysiological challenges due to the coexistence of the patient's native heart and the transplanted donor organ. CASE SUMMARY: We present the case of a 56-year-old man who experienced recurrent ventricular arrhythmias 6 years post-HHT. The patient initially presented with a syncope and ventricular tachyarrhythmia originating from the donor heart while the native heart maintained sinus rhythm. The arrhythmogenic substrate was attributed to transplant vasculopathy in the donor heart. Management required implantable cardioverter-defibrillator placement and antiarrhythmic therapy. DISCUSSION: This case demonstrates the fundamental electrophysiological principle that simultaneous documentation of 2 different cardiac rhythms necessitates the presence of 2 independent cardiac rhythms. Although HHT is now rarely performed, this case provides insights into the cardiac electrophysiology and management of dual arrhythmogenic substrates. TAKE-HOME MESSAGES: Two simultaneously detectable rhythms in the surface electrocardiogram provide compelling evidence of the presence of 2 independent cardiac excitation systems. Even a dysfunctional native heart may maintain consciousness during sustained polymorphic ventricular tachycardia of the donor heart through parallel circulation over a limited period of some hours.

Indexed as

electrocardiographyheterotopic heart transplantationtransplant vasculopathyventricular arrhythmia

Identifiers

PMID42165468
PMCPMC13198136

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.