Management of ventricular arrhythmias in patients with LVAD

Maradey, Joan; Singleton, Matthew J.; O’Neill, Thomas; Bhave, Prashant D.

doi:10.1097/hco.0000000000000730

Cited by 10 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Approximately 20% of patients with LVAD experience VAs, mostly ventricular fibrillation, after LVAD implantation (3). A history of preimplant VAs, atrial fibrillation, prior cardiac surgery, and nonischemic cardiomyopathy; heart failure duration prior to LVAD (>12 months); advanced age; scarring at the cannula insertion sites; pump suction rates; and electrolyte disturbances have been reported as the most common causes of arrhythmias that develop after LVAD implantation (2,4,5). It has been reported that VAs are more common in the early period of LVAD implantation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A stable patient with a left ventricular assist device was admitted to the outpatient clinic with ventricular fibrillation

Doǧan¹,

Arslan²,

Özyıldırım³

et al. 2021

The Anatolian Journal of Cardiology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…Ventricular arrhythmias (VAs) are one of the most critical complications that develop in patients with LVAD. VAs are common in the first 30 days of LVAD implantation (1,2). Although it has been reported that arrhythmias are generally well tolerated by patients with LVAD, their effects on mortality are still controversial.…”

Section: Introductionmentioning

confidence: 99%

A stable patient with a left ventricular assist device was admitted to the outpatient clinic with ventricular fibrillation

Doǧan¹,

Arslan²,

Özyıldırım³

et al. 2021

The Anatolian Journal of Cardiology

View full text Add to dashboard Cite

“…Nonetheless, a recent systematic review of 18 studies showed that catheter ablation was associated with a decrease in rates of ICD therapies (57 vs. 24%), but VD recurred in 44% at a mean follow-up of 264 days [22].…”

Section: Mechanisms and Management Of Ventricular Dysrhythmiasmentioning

confidence: 99%

Implantable Cardioverter-Defibrillator Use in Patients with Left Ventricular Assist Devices

Garcia-Molinero,

Toro

2023

Ventricular Assist Devices - Advances and Applications in Heart Failure

View full text Add to dashboard Cite

This chapter is developed with the intention of discussing the use of implantable defibrillator cardioverters (ICDs) in patients with left ventricular assist devices (LVADs). LVADs have become the standard treatment for patients with advanced heart failure who require prolonged mechanical circulatory support as a bridge to transplantation or as destination therapy. Patients with advanced heart failure have a major risk of sudden death due to ventricular dysrhythmias (VD) so an ICD could be indicated, but it remains unclear within the LVAD population due to several factors including sustained VD good tolerance and inappropriate therapies (due to supraventricular tachycardias or electromechanical interferences) as well as the risk of infections with complex antibiotic therapy or device replacements. Previous VD before LVAD placement, concomitant atrial fibrillation, type of LVAD device, and chronic ischemic heart disease can predict future episodes of VD. The evidence that supports ICD use in patients with LVAD is very limited, and current guidelines are based primarily on the consensus of experts and observational studies. Nowadays, an ICD implant is only recommended for LVAD patients who develop postoperative VD associated with hemodynamic collapse, and it should be programmed in a very conservative mode (higher rate and larger intervals to detection) to avoid undesirable electric shocks.

show abstract

“…Scar-Related Reentrant Arrhythmia Potential cardiomyopathy after LVAD implantation is frequently accompanied by visible scar formation, which may be the cause of reentrant arrhythmia [30]. A metaanalysis showed that scar-related reentrant arrhythmia is the main mechanism of VT after LVAD implantation [31].…”

Section: Mechanical Effectmentioning

confidence: 99%

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

Shi

Liu³

2022

Cardiology

View full text Add to dashboard Cite

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.

show abstract

Management of ventricular arrhythmias in patients with LVAD

Cited by 10 publications

References 38 publications

A stable patient with a left ventricular assist device was admitted to the outpatient clinic with ventricular fibrillation

A stable patient with a left ventricular assist device was admitted to the outpatient clinic with ventricular fibrillation

Implantable Cardioverter-Defibrillator Use in Patients with Left Ventricular Assist Devices

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

Contact Info

Product

Resources

About