Suction Events During Left Ventricular Support and Ventricular Arrhythmias

Vollkron, Michael; Voitl, Peter; Ta, Julia; Wieselthaler, Georg; Schima, Heinrich

doi:10.1016/j.healun.2007.05.011

Cited by 141 publications

(84 citation statements)

References 21 publications

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“…Another possible mechanism is suction applied to an adjacent ventricular wall from the cannula, 16 which occurred in at least one of our patients in whom a change of turbine speed from 9400 to 9000 rpm extinguished VT. The surgeon should be aware of this complication to prevent it.…”

Section: Discussionmentioning

confidence: 87%

Characteristics of Ventricular Tachycardia Ablation in Patients With Continuous Flow Left Ventricular Assist Devices

Sacher

Reichlin

Zado

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-Left ventricular assist devices (LVADs) are increasingly used as a bridge to cardiac transplantation or as destination therapy. Patients with LVADs are at high risk for ventricular arrhythmias. This study describes ventricular arrhythmia characteristics and ablation in patients implanted with a Heart Mate II device. Methods and Results-All patients with a Heart Mate II device who underwent ventricular arrhythmia catheter ablation at 9 tertiary centers were included. Thirty-four patients (30 male, age 58±10 years) underwent 39 ablation procedures. The underlying cardiomyopathy pathogenesis was ischemic in 21 and nonischemic in 13 patients with a mean left ventricular ejection fraction of 17%±5% before LVAD implantation. One hundred and ten ventricular tachycardias (VTs; cycle lengths, 230-740 ms, arrhythmic storm n=28) and 2 ventricular fibrillation triggers were targeted (25 transseptal, 14 retrograde aortic approaches). Nine patients required VT ablation <1 month after LVAD implantation because of intractable VT. Only 10/110 (9%) of the targeted VTs were related to the Heart Mate II cannula. During follow-up, 7 patients were transplanted and 10 died. Of the remaining 17 patients, 13 were arrhythmia-free at 25±15 months. In 1 patient with VT recurrence, change of turbine speed from 9400 to 9000 rpm extinguished VT. Conclusions-Catheter ablation of VT among LVAD recipients is feasible and reasonably safe even soon after LVAD implantation. Intrinsic myocardial scar, rather than the apical cannula, seems to be the dominant substrate.

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Section: Discussionmentioning

confidence: 87%

Characteristics of Ventricular Tachycardia Ablation in Patients With Continuous Flow Left Ventricular Assist Devices

Sacher

Reichlin

Zado

et al. 2015

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

show abstract

“…30 A significant increase in monomorphic VT was also seen in a study of LVAD suction events. 22 Suction events result from mismatch between LVAD outflow and inflow when left ventricular filling does not match the LVAD output. In such a scenario, the left ventricle is excessively unloaded and can partially or fully collapse, which can induce sustained or nonsustained VA that are monomorphic or polymorphic.…”

Section: Potential Mechanismsmentioning

confidence: 99%

Ventricular Arrhythmias After Left Ventricular Assist Device

Nakahara

Chien

Gelow

et al. 2013

Circ: Arrhythmia and Electrophysiology

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“…• Mechanical problems related to the LVAD, valve conduit, right ventricular dysfunction or ischemia, tricuspid regurgitation, aortic regurgitation with shunting of LVAD output, pulmonary vascular resistance, systemic vascular resistance, and patent foramen ovale with hypoxemia 61,62 • Interpretation of LVAD-related hemodynamics based on noninvasive, invasive, and console data • Supraventricular and ventricular arrhythmias pertinent to the device, such as suction events with axial flow devices 63 • Hematological issues, including bleeding and thrombosis associated with antiplatelet and anticoagulant therapy, 64 and device-related hemolysis • Infectious complications 65 This HF specialist should also be knowledgeable in the following areas:…”

Section: Perioperative Management Of Patients Requiring Mechanical Dementioning

confidence: 99%

ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Transplant

Francis¹,

Greenberg²,

Hsu³

et al. 2010

Circulation

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Suction Events During Left Ventricular Support and Ventricular Arrhythmias

Cited by 141 publications

References 21 publications

Characteristics of Ventricular Tachycardia Ablation in Patients With Continuous Flow Left Ventricular Assist Devices

Characteristics of Ventricular Tachycardia Ablation in Patients With Continuous Flow Left Ventricular Assist Devices

Ventricular Arrhythmias After Left Ventricular Assist Device

ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Transplant

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