Residual recipient right atrial tissue responsive to atropine 10 years following ‘bi-caval’ orthotopic heart–lung transplantation

A 51-year-old-man who had undergone a heart–lung transplant by ‘bi-caval’ anastomosis technique demonstrated residual recipient right atrial (RA) electrical activity responsive to muscarinic blockade 10 years after the surgery. The presumably initially denervated donor RA proved to be responsive to muscarinic blockade as well.