Arrhythmias after Implantation of the Left Ventricular Assisted Device

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.