Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation
SourceJournal of Cardiothoracic Surgery, 11, 1, (2016), pp. 97, article 97
Article / Letter to editor
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Journal of Cardiothoracic Surgery
SubjectRadboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences
BACKGROUND: Early postoperative ventricular tachyarrhythmia (PoVT) after left ventricular assist device (LVAD) implantation are common and associated with higher mortality-rates. At present, there is no data on initiation of these PoVT and the role of alterations in cardiac hemodynamics. CASE PRESENTATION: A LVAD was implanted in a patient with end-stage heart failure due to a ischemic cardiomyopathy. Alterations in cardiac rhythm and hemodynamics preceding PoVT-episodes during the first five postoperative days were examined by using continuous recordings of cardiac rhythm and various hemodynamic parameters. All PoVT (N=120) were monomorphic, most often preceded by short-long-short-sequences or regular SR and initiated by ventricular runs. Prior to PoVT, mean arterial pressure decreased; heart rate and ST-segments deviations increased. CONCLUSIONS: PoVT are caused by different underlying electrophysiological mechanisms. Yet, they are all monomorphic and preceded by hemodynamic deterioration due to myocardial ischemia.
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