Ventricular Fibrillation 7 Years After Left Ventricular Assist Device Implantation

Eyituoyo, Harry O; Aben, Rieta N; Arinze, Nkechi C; Vu, Dat P; James, Erskine A.

doi:10.12659/ajcr.923711

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…Theoretically, VF occurs with the stop of native right ventricular contraction instantly followed by pulmonary circulation arrest, resulting in CF-LVAD dysfunction due to insufficient preload. However, patients with CF-LVAD support can survive with less severe clinical symptoms during onset VF, and in short period there may be no serious signs of hemodynamic failure ( 4 – 7 , 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, the VF following CF-LVAD implantation is accompanied by complete loss of the right ventricular squeezing, leading to reductions in CF-LVAD preload and cardiac output, which eventually results in circulatory collapse. To the contrary, no clinical signs of serious circulatory failure are found in VF patients with CF-LVAD in the shorter term, instead some non-specific symptoms such as fatigue, chest tightness or drowsiness ( 4 – 7 ).…”

Section: Introductionmentioning

confidence: 98%

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The role of atria in ventricular fibrillation after continuous-flow left ventricular assist device implantation in ovine model

Shi²,

Rong³

et al. 2023

Front. Cardiovasc. Med.

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ObjectivesThis study attempted to explore the hemodynamics and potential mechanisms driving pulmonary circulation in status of ventricular fibrillation (VF) following continuous-flow left ventricular assist device (CF-LVAD) implantation.MethodsAn ovine CF-LVAD model was built in small-tailed Han sheep, with the pump speed set as 2,400 rpm. VF was induced following ventricular tachycardia using a temporary pacemaker probe to stimulate the right and left ventricular free walls. The central venous pressure (CVP), pump flow (PF), pulmonary artery flow (PAF) and other major indicators were observed and recorded after VF.ResultsLow-flow systemic and pulmonary circulation could be sustained for 60 min under VF with sinus atrial rhythm after CF-LVAD implantation. The CVP gradually increased. The mean PF declined from 1.80 to 1.20 L/min, and the mean PAF decreased from 1.62 L/min to 0.87 L/min. Under VF with atrial fibrillation, the systemic and pulmonary circulation couldn’t be sustained. The CVP jumped from the 5 mmHg baseline to 12 mmHg, the mean PF rapidly decreased from 3.45 L/min to 0.79 L/min, and the PAF declined from 3.94 L/min to 0.77 L/min.ConclusionThe atrial rhythm and function might be essential for the circulation maintenance in patients with VF after CF-LVAD implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

The role of atria in ventricular fibrillation after continuous-flow left ventricular assist device implantation in ovine model

Shi²,

Rong³

et al. 2023

Front. Cardiovasc. Med.

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“…Na presença do DAVLP funcionando, com o paciente inconsciente, sinais de baixa perfusão e identificado o alarme do baixo fluxo (low flow) é necessário avaliar a monitorização cardíaca, se apresentar ritmo de parada cardiorrespiratória, prosseguir com o atendimento do ACLS, sem restrição para compressões torácica e em caso de Fibrilação Ventricular (FV) e Taquicardia Ventricular (TV) deve realizar a desfibrilação ou cardioversão cardíaca (Bowles et al, 2017;Busch et al, 2011;Eyituoyo et al, 2020;Fitzgibbon et al, 2016;Givertz et al, 2019;Patel et al, 2011;Peberdy et al, 2017;Perim et al, 2019;Pistono et al, 2013).…”

Section: Discussionunclassified

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

Prado,

Saraiva,

Santos

et al. 2023

RSD

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Objetivo: Construir um fluxograma de atendimento de emergências cardiovasculares em pacientes portadores de Dispositivos de Assistência Ventricular de Longa Permanência. Metodologia: Estudo metodológico para elaboração do fluxograma de atendimento de emergências cardiovasculares aos pacientes em uso de Dispositivos de Assistência Ventricular de Longa Permanência baseado na revisão integrativa da literatura, nas bases e/ou portais Biblioteca Virtual em Saúde, Pubmed, Scopus, Cinahl e Web of Science, sem definição de tempo inicial até fevereiro de 2023. Resultado: Foram encontrados 3 artigos com maior evidência científica sobre a reanimação cardiopulmonar em pacientes com implante de Dispositivos de Assistência Ventricular de Longa Permanência, onde sugerem a segurança das compressões torácicas no atendimento de emergência cardiovascular desses pacientes. Para a construção do fluxograma foi utilizado os artigos de revisão da literatura, adequando para a realidade vivida nos hospitais brasileiros. Conclusão: O atendimento dos pacientes com dispositivo de assistência ventricular necessita de conhecimento e preparo da equipe multiprofissional para não atrasar a identificação e tomada de decisão. É necessário estudos maiores e com relevância metodológica mais robusta para garantir a eficácia da conduta do profissional, garantindo segurança para o paciente.

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“…A physical examination revealed VF, which was treated with electrical cardioversion. Other similar reports [13-15] also documented that the patients’ circulation was relatively stable and clinical symptoms were modest. Long-term VA persistence or recurrence following LVAD implantation is linked to hemodynamic failure [11].…”

Section: Case Reports and Epidemiological Studiesmentioning

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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Ventricular Fibrillation 7 Years After Left Ventricular Assist Device Implantation

Cited by 5 publications

References 11 publications

The role of atria in ventricular fibrillation after continuous-flow left ventricular assist device implantation in ovine model

The role of atria in ventricular fibrillation after continuous-flow left ventricular assist device implantation in ovine model

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

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

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