Complete Atrioventricular Block Decreases Left Ventricular Assist Device Flow Rate

Leadless pacemaker implantation in a patient with a fully magnetically levitated left ventricular assist device

“…RV pacing in patients with an LVAD and a complete AV block supports the functioning of the RV and increases the LVAD flow. 5,6 In contrast, the use of a CRT-D is not associated with improved survival of patients with end-stage heart failure with LVADs. 7,8 Therefore, using a leadless PM might be an effective approach to treat bradycardia in patients with LVADs and high susceptibility to infection, like in our case.…”

“…RV pacing in patients with an LVAD and a complete AV block supports the functioning of the RV and increases the LVAD flow 5,6 . In contrast, the use of a CRT‐D is not associated with improved survival of patients with end‐stage heart failure with LVADs 7,8 .…”

Leadless pacemaker use in a patient with a durable left ventricular assist device

“…To our knowledge, this case represents the first described use of the Micra transcatheter pacing system in a patient with a VAD. In patients with a VAD and underlying bradyarrhythmias, the use of pacing supports the right ventricle to aid circulation through the pulmonary system that allows for increased LVAD flows and systemic circulation 2,3 . In most patients with severe left ventricular systolic dysfunction, a traditional transvenous pacemaker and defibrillator can accomplish this task, but the benefit of treating tachyarrhythmias with an implanted defibrillator has not been clearly determined in the current generation of VADs 4,5 .…”

“…system that allows for increased LVAD flows and systemic circulation. 2,3 In most patients with severe left ventricular systolic dysfunction, a traditional transvenous pacemaker and defibrillator can accomplish this task, but the benefit of treating tachyarrhythmias with an implanted defibrillator has not been clearly determined in the current generation of VADs. 4,5 In selected individuals without a history of ventricular tachyarrhythmias requiring therapies, a pacing only system may be reasonable.…”

Recurrence of heart failure symptoms after LVAD placement due to bradycardia-induced inflow obstruction

“…3,4 This would potentially lead to improved left ventricular filling and reduced likelihood of a suction event. 1,2 Herein we have described a dynamic obstruction of the LVAD related to bradycardia and pauses.…”