Abstract
Cardiac arrhythmias has been frequently reported after left ventricular assist devices implantation butcurrently literature shows no sufficient information on cardiac arrhythmias. Objective: The aim of thisstudy was to assess the frequency and other features of ventricular and supra ventricular ectopic beats((SVEB), atrial fibrillation (AF)/ flutter (AFL) post device implantation. Methods: This is a retrospectivestudy conducted in Department of Cardiac-Surgery, University of Verona Medical School, Verona, Italyfrom June 2014-September 2016. Rhythm monitoring and registration were collected from 16 patients (13males; 45±13years) during the first five (05) days after implantation. To assess late post-operative rhythm,patient’s hospital electronic records were used as well as functional hemodynamic parameters includingmean arterial pressure (MAP), right atrial pressure (RAP), heart rate (HR) and ST-deviation(d-ST).Results: Ventricular arrhythmia (n=9), atrial fibrillation (n=5) or atrial flutter (n=2) episodes werepreoperatively present in 11 patients. Postoperatively, 5 patients developed either VT (n=2), AF (n=1) orboth VT/AF (n=2) during a follow-up of 18±14 months. Prior to postoperative VT (POVT) episodes (n=123),MAP decreased, HR, d-ST increased and RAP remained unaltered. POVT were initiated either by singleVEBS (28%), V-couplets (15%), V-run (46%) or occurred suddenly (11%). Conclusions: Ventricular andsupraventricular arrhythmias are common after device implantation. The frequency of sustained VTA wasless at early phase as compared to late postoperative phase.
Highlights
A left ventricular assisted device (LVAD) serves as a bridge to transplant in patients with endstage heart failure [1]
One patient was temporarily supported by an intra-aortic balloon pump (IABP) and another by extracorporeal membrane oxygenation (ECMO) at LVAD implantation
Previous studies demonstrated that VTA are the most common tachyarrhythmia observed after LVAD implantation; the reported incidence ranges from 18% up to 52% [3,4,5, 11,12,13,14,15,16]
Summary
A left ventricular assisted device (LVAD) serves as a bridge to transplant in patients with endstage heart failure [1]. Mortality rates among patients with VTA early after LVAD implantation are higher than those among. Previous studies examining rhythm disorders prior to or after LVAD implantation focused only on sustained VTA [8, 9]; the presence of other types of dysrhythmias and their interrelationship have never been described. The aim of this study was to examine 1) the frequency and characteristics of (supra) ventricular ectopy and (supra) ventricular (non)-sustained tachyarrhythmia, 2) the interrelationship between ectopy and sustained tachycardia and 3) hemodynamic alterations preceding episodes of sustained tachycardia before and in the first five days after (re)implantation of the Left Ventricular Assisted Device by using continuous rhythm registrations. The time course of every dysrhythmia before hospital admission for device implantation to either heart transplantation or death was surveyed
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