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Ventricular Tachycardia Associated with Left Ventricular Assist Device

  • J. Anthony GomesEmail author
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Abstract

Left ventricular assist devices (LVADs) are used in patients with severe Class IIIB and IV CHF as a bridge to transplantation or destination therapy. These devices have extended the life of severely ill patients with more than 2,500 implants annually in the USA and a 1-year survival of about 80%. Almost all patients who receive a LVAD have an implantable defibrillator (ICD) or a biventricular ICD for resynchronization therapy. In this chapter, the author discusses the incidence of ventricular arrhythmias and their mechanisms and outcome in LVAD patients, the impact of ICD and CRT-D in LVAD patients, and the medical and catheter ablation of VT in patients with LVADs.

Keywords

Storm LVAD Programming ICD CRT-D Amiodarone Torsade de pointes 

References

  1. 1.
    Mancini D, Colombo PC. Left ventricular assist devices: a rapidly evolving alternative to transplant. J Am Coll Cardiol. 2015;65:2542–55.PubMedGoogle Scholar
  2. 2.
    Kirklin JK, Naftel DC, Pagani FD, et al. Seventh INTERMACS annual report: 15,000 patients and counting. J Heart Lung Transplant. 2015;34:1495–504.PubMedGoogle Scholar
  3. 3.
    Garan A, Yuzefpolskaya M, Colombo P, et al. Ventricular arrhythmias and implantable cardioverter-defibrillator therapy in patients with continuous-flow left ventricular assist devices. J Am Coll Cardiol. 2013;61:2542–50.PubMedGoogle Scholar
  4. 4.
    Oswald H, Schultz-Wildelau C, Gardiwal A, et al. Implantable defibrillator therapy for ventricular tachyarrhythmias in left ventricular assist device patients. Eur J Heart Fail. 2010;12:593–9.PubMedGoogle Scholar
  5. 5.
    Bedi M, Kormos R, Winowich S, et al. Ventricular arrhythmias during left ventricular assist device support. Am J Cardiol. 2007;99:1151–3.PubMedGoogle Scholar
  6. 6.
    Ziv O, Dizon J, Thosani A, et al. Effects of left ventricular assist device therapy on ventricular arrhythmias. J Am Coll Cardiol. 2005;45:1428–34.PubMedGoogle Scholar
  7. 7.
    Cantillon D, Tarakii K, Kumbhabi D, et al. Improved survival among ventricular assist device recipients with a concomitant implantable cardioverter defibrillator. Heart Rhythm. 2010;7:466–71.PubMedGoogle Scholar
  8. 8.
    Raasch H, Jensen BC, Chang PP, et al. Epidemiology, management and outcomes of sustained ventricular arrhythmias after continuous-flow left ventricular assist devices. Am Heart J. 2012;164:373–8.PubMedGoogle Scholar
  9. 9.
    Refaat M, Chemaly E, Lebeche D, et al. Ventricular arrhythmias after left ventricular assist device implantation. Pacing Clin Electrophysiol. 2008;31:1246–52.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Harding J, Piacentino V, Tothman S, et al. Prolonged repolarization after ventricular assist device support is associated with arrhythmias in humans with congestive heart failure. J Card Fail. 2005;11:227–32.PubMedGoogle Scholar
  11. 11.
    Boilson BA, Durham LA, Park SJ. Ventricular fibrillation in an ambulatory patient supported by a left ventricular assist device: highlighting the ICD controversy. ASAIO J. 2012;58:170–3.PubMedGoogle Scholar
  12. 12.
    Patel P, Williams JG, Brice JH. Sustained ventricular fibrillation in an alert patient: preserved hemodynamics with a left ventricular assist device. Prehosp Emerg Care. 2011;15:533–6.PubMedGoogle Scholar
  13. 13.
    Sims DB, Rosner G, Uriel N, et al. Twelve hours of sustained ventricular fibrillation supported by a continuous-flow left ventricular assist device. Pacing Clin Electrophysiol. 2012;35:e144–8.PubMedGoogle Scholar
  14. 14.
    Enriquez AD, Calenda B, Miller MA, et al. The role of implantable cardioverter-defibrillator in patient with continuous flow left ventricular assist devices. Circ Arrhythm Electrophysiol. 2013;6:668–74.PubMedGoogle Scholar
  15. 15.
    Stewart GC, Brooks K, Pratibhu PP, et al. Thresholds of physical activity and life expectancy for patients considering destination ventricular assist devices. J Heart Lung Transplant. 2009;28:863–9.PubMedGoogle Scholar
  16. 16.
    Refaat MM, Tanaka T, Kormos RL, et al. Survival benefit of implantable cardioverter-defibrillators in left ventricular assist device-supported heart failure patients. J Card Fail. 2012;18(2):140–5.PubMedGoogle Scholar
  17. 17.
    Enriquez AD, Calenda B, Miller MA, Anyanwu AC, Pinney SP. The role of implantable cardioverter-defibrillators in patients with continuous flow left ventricular assist devices. Circ Arrhythm Electrophysiol. 2013;6:668–74.  https://doi.org/10.1161/CIRCEP.113.000457.CrossRefPubMedGoogle Scholar
  18. 18.
    Lee W, Tay A, Subbiah RN, Walker BD, et al. Impact of implantable cardioverter defibrillators on survival of patients with centrifugal left ventricular assist devices. Pacing Clin Electrophysiol. 2015;38:925–33.PubMedGoogle Scholar
  19. 19.
    Younes A, Al-Kindi SG, Alajaji W, et al. Presence of implantable cardioverter-defibrillators and wait-list mortality of patients supported with left ventricular assist devices as bridge to heart transplantation. Int J Cardiol. 2017;231:211–5.PubMedGoogle Scholar
  20. 20.
    Clerkin KJ, Topkara VK, Mancini DM, et al. The role of implantable cardioverter defibrillators in patients bridged to transplantation with a continuous-flow left ventricular assist device: a propensity score matched analysis. J Heart Lung Transplant. 2017;36:633–9.PubMedGoogle Scholar
  21. 21.
    Clerkin KJ, Topkara VK, Demmer RT, et al. Implantable cardioverter-defibrillators in patients with a continuous-flow left ventricular assist device: an analysis of the INTERMACS registry. JACC Heart Fail. 2017;5:916–26.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Agrawal S, Garg L, Nanda S, et al. The role of implantable cardioverter-defibrillators in patients with continuous flow left ventricular assist devices: a meta-analysis. Int J Cardiol. 2016;222:379–84.PubMedGoogle Scholar
  23. 23.
    Vakil K, Kazmirczak F, Sathnur N, et al. Implantable cardioverter-defibrillator use in patients with left ventricular assist devices: a systematic review and meta-analysis. JACC Heart Fail. 2016;4:772–9.PubMedGoogle Scholar
  24. 24.
    Omery B, Pedersen R, Sulemanjee N, et al. Implication of appropriate ICD shock on mortality after continuous flow LVAD. J Heart Lung Transplant. 2018;37(4S):310.Google Scholar
  25. 25.
    Gopinathannair R, Cornwell WK, Dukes JW, et al. Device therapy and arrhythmia management in left ventricular assist device recipients a scientific statement from the American Heart Association. Circulation. 2019;139  https://doi.org/10.1161/CIR.0000000000000673.
  26. 26.
    Richardson TD, Hale L, Arteaga C, et al. Prospective randomized evaluation of implantable cardioverter-defibrillator programming in patients with a left ventricular assist device. J Am Heart Assoc. 2018;7:e007748.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Migliore F, Leoni L, Bottio T, et al. Subcutaneous implantable cardioverter-defibrillator and left ventricular assist device: a safe and effective approach for refractory heart failure. JACC Clin Electrophysiol. 2016;2:246–7.PubMedGoogle Scholar
  28. 28.
    Saeed D, Albert A, Westenfeld R, et al. Left ventricular assist device in a patient with a concomitant subcutaneous implantable cardioverter defibrillator. Circ Arrhythm Electrophysiol. 2013;6:e32–3.PubMedGoogle Scholar
  29. 29.
    Gupta A, Subzposh F, Hankins SR, Kutalek SP. Subcutaneous implantable cardioverter-defibrillator implantation in a patient with a left ventricular assist device already in place. Tex Heart Inst J. 2015;42:140–3.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Saini H, Saini A, Leffler J, et al. Subcutaneous implantable cardioverter defibrillator (S-ICD) shocks in a patient with a left ventricular assist device. Pacing Clin Electrophysiol. 2018;41:309–11.PubMedGoogle Scholar
  31. 31.
    Pfeffer TJ, Konig T, Duncker D, et al. Subcutaneous implantable cardioverter-defibrillator shocks after left ventricular assist device implantation. Circ Arrhythm Electrophysiol. 2016;9:e004633.PubMedGoogle Scholar
  32. 32.
    Gopinathannair R, Birks EJ, Trivedi JR, et al. Impact of cardiac resynchronization therapy on clinical outcomes in patients with continuous-flow left ventricular assist devices. J Card Fail. 2015;21:226–32.PubMedGoogle Scholar
  33. 33.
    Schleifer JW, Mookadam F, Kransdorf EP, et al. Effect of continued cardiac resynchronization therapy on ventricular arrhythmias after left ventricular assist device implantation. Am J Cardiol. 2016;118:556–9.PubMedGoogle Scholar
  34. 34.
    Gopinathannair R, Roukoz H, Bhan A, et al. Cardiac resynchronization therapy and clinical outcomes in continuous flow left ventricular assist device recipients. J Am Heart Assoc. 2018;7:e009091.  https://doi.org/10.1161/JAHA.118.009091.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Dandamudi G, Ghumman WS, Das MK, Miller JM. Endocardial catheter ablation of ventricular tachycardia in patients with ventricular assist devices. Heart Rhythm. 2007;4:1165–9.PubMedGoogle Scholar
  36. 36.
    Hottigoudar RU, Deam AG, Slaughter MS, et al. Ventricular tachycardia ablation in patients with HeartMate II left ventricular assist devices: rhythm still matters in the bionic age. J Innovations Cardiac Rhythm Manage. 2011;2:537–47.Google Scholar
  37. 37.
    Cantillon DJ, Bianco C, Wazni OM, et al. Electrophysiologic characteristics and catheter ablation of ventricular tachyarrhythmias among patients with heart failure on ventricular assist device support. Heart Rhythm. 2012;9:859–64.PubMedGoogle Scholar
  38. 38.
    Herweg B, Ilercil A, Kristof-Kuteyeva O, et al. Clinical observations and outcome of ventricular tachycardia ablation in patients with left ventricular assist devices. Pacing Clin Electrophysiol. 2012;35:1377–83.PubMedGoogle Scholar
  39. 39.
    Garan AR, Iyer V, Whang W, et al. Catheter ablation for ventricular tachyarrhythmias in patients supported by continuous-flow left ventricular assist devices. ASAIO J. 2014;60:311–6.PubMedGoogle Scholar
  40. 40.
    Sacher F, Reichlin T, Zado ES, et al. Characteristics of ventricular tachycardia ablation in patients with continuous flow left ventricular assist devices. Circ Arrhythm Electrophysiol. 2015;8:592–7.PubMedGoogle Scholar
  41. 41.
    Snipelisky D, Reddy YN, Manocha K, et al. Effect of ventricular arrhythmia ablation in patients with Heart Mate II left ventricular assist devices: an evaluation of ablation therapy. J Cardiovasc Electrophysiol. 2017;28:68–77.PubMedGoogle Scholar
  42. 42.
    Moss JD, Flatley EE, Beaser AD, et al. Characterization of ventricular tachycardia after left ventricular assist device implantation as destination therapy: a single-center ablation experience. JACC Clin Electrophysiol. 2017;3:1412–24.PubMedGoogle Scholar
  43. 43.
    Mulloy DP, Bhamidipati CM, Stone ML, et al. Cryoablation during left ventricular assist device implantation reduces postoperative ventricular tachyarrhythmias. J Thorac Cardiovasc Surg. 2013;145:1207–13.PubMedGoogle Scholar
  44. 44.
    Patel M, Rojas F, Shabari FR, et al. Safety and feasibility of open chest epicardial mapping and ablation of ventricular tachycardia during the period of left ventricular assist device implantation. J Cardiovasc Electrophysiol. 2016;27:95–101.PubMedGoogle Scholar
  45. 45.
    McIlvennan CK, Babu AN, Brieke A, Ambardekar AV. Concomitant surgical cryoablation for refractory ventricular tachycardia and left ventricular assist device placement: a dual remedy but a recipe for thrombosis? J Cardiothorac Surg. 2016;11:53.  https://doi.org/10.1186/s13019-016-0451-x.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Icahn School of MedicineMount Sinai HospitalNew YorkUSA

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