Electrical storm in patients with left ventricular assist devices: Risk factors, incidence, and impact on survival

Rehorn, Michael; Black‐Maier, Eric; Loungani, Rahul S.; Sen, Sounok; Sun, Albert Y.; Friedman, Daniel J.; Koontz, Jason I.; Schroder, Jacob N.; Milano, Carmelo A.; Khouri, Michel G.; Katz, Jason N.; Patel, Chetan B.; Pokorney, Sean D.; Daubert, James P.; Piccini, Jonathan P.

doi:10.1016/j.hrthm.2021.03.047

Cited by 16 publications

(22 citation statements)

References 20 publications

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“…An understanding of the risk factors or predictors of VA may help doctors diagnose the disease early and intervene when necessary [ 39 ]. A preoperative VA history is considered a predictor of VA following LVAD implantation in most studies and, in some cases, is the only predictor of long-term VA after LVAD implantation [ 19 , 23 , 40 , 41 , 42 , 43 , 44 ]. Raasch et al [ 45 ] studied 61 LVAD-assisted patients.…”

Section: Discussionmentioning

confidence: 99%

A Review of New-Onset Ventricular Arrhythmia after Left Ventricular Assist Device Implantation

Shi

Liu³

2022

Cardiology

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Introduction: Heart failure (HF) is a severe and terminal stage of various heart diseases. Left ventricular assist devices (LVADs) are relatively mature and have contributed to the treatment of end-stage HF. Ventricular arrhythmia (VA) is a common complication after LVAD implantation, including ventricular tachycardia and ventricular fibrillation, both of which may cause abnormal circulation. Methods: A literature search was conducted in the PubMed database, “Ventricular Arrhythmia” OR “VA” OR “Arrhythmia” OR “Ventricular Tachycardia,” OR “Ventricular Fibrillation” AND “LVAD” OR “Left Ventricular Assist Device” OR “Heart Assist Device” as either keywords or MeSH terms, the authors screened the titles and abstracts of the articles. Eventually, 12 original research articles were retrieved. Results: The 0.83 [95% CI: 0.77, 0.89] of patients were male. A whole of 53% [95% CI: 0.25, 0.81] of VA patients had a history of atrial fibrillation and 61% [95% CI: 0.52, 0.69] had a history of VA. 39% [95% CI: 0.29, 0.49] of the participants had no prior history of VA and experienced new VA following CF-LVAD implantation. Following CF-LVAD implantation, 59% [95% CI: 0.51, 0.67] of patients developed early VA (VA ≤30 days). The 30-day mortality rate of patients was 4% [95% CI: 0.01, 0.07]. And overall mortality was 28% [95% CI: 0.15, 0.41]. The reported incidence of VA after LVAD implantation is not identical in different medical centers and ranges from 20% to 60%. The mechanism of VA after LVAD implantation is summarized as primary cardiomyopathy-related, device mechanical stimulation, myocardial scarring, ventricular displacement, electrolyte regulation, and other processes. Conclusions: A preoperative VA history is considered a predictor of VA following LVAD implantation in most studies. Multiple mechanisms and factors, such as prevention of “suction events,” ablation, and implantable cardioverter defibrillator, should be considered for the prevention and treatment of postoperative VA in patients requiring long-term VAD treatment. This study provides a reference for the clinical application of LAVD and the prevention of postoperative VA after LVAD implantation. Future multicenter prospective studies with uniform patient follow-up are needed to screen for additional potential risk factors and predictors. These studies will help to define the incidence rate of VA after LAVD implantation. As a result, we provide guidance for the selection of preventive intervention.

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Section: Discussionmentioning

confidence: 99%

A Review of New-Onset Ventricular Arrhythmia after Left Ventricular Assist Device Implantation

Shi

Liu³

2022

Cardiology

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“…[3][4] The development of electrical storm, defined as 3 or more episodes of VA in <24 hour period, is even more strongly associated with increased mortality in this population. 5 Catheter ablation for treatment of VT is a particularly important tool for treating patients with LVADs, yet, there are a variety of unique anatomical obstacles to achieving a safe and effective ablation.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Refractory hypoxemia from intracardiac shunting following ventricular tachycardia ablation in a patient with a left ventricular assist device

Oates

Towheed²,

Hadadi³

2022

HeartRhythm Case Reports

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“…The left ventricular assist device (LVAD) support significantly reduces mortality in endstage heart failure patients and potentially restores eligibility for heart transplantation in patients with initially significant pulmonary hypertension [1,2]. Ventricular fibrillation and asystole lead to a decrease in right ventricular output and left ventricular preload, which significantly diminishes efficiency of LVAD support [3][4][5]. In this clinical vignette, we present a patient with an implanted continuous-flow LVAD (CF-LVAD) who developed permanent asystole as a consequence of an electric storm.…”

mentioning

confidence: 99%

Permanent cardiac arrest in a patient with a left ventricular assist device support

et al. 2022

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Electrical storm in patients with left ventricular assist devices: Risk factors, incidence, and impact on survival

Cited by 16 publications

References 20 publications

A Review of New-Onset Ventricular Arrhythmia after Left Ventricular Assist Device Implantation

A Review of New-Onset Ventricular Arrhythmia after Left Ventricular Assist Device Implantation

Refractory hypoxemia from intracardiac shunting following ventricular tachycardia ablation in a patient with a left ventricular assist device

Permanent cardiac arrest in a patient with a left ventricular assist device support

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