This is a case of atrial tachycardia 2 years after pulmonary transplantation.

We discuss arrhythmia mechanism found after pulmonary transplantation and benefit of noninvasive electrocardiographic mapping for procedure planning.

This case shows that long-term extracorporeal lung assist is a viable but demanding alternative for bridging patients to pulmonary transplantation.

Rapid advances have occurred involving indications and operative management that have allowed pulmonary transplantation to be a viable option for an increasingly diverse patient population.

Setting: Duke University Medical Center, Pulmonary Transplantation Program.