Clinical impact of newly developed atrial fibrillation complicated with longstanding ventricular fibrillation during left ventricular assist device support: A case report

BMC Cardiovasc Disord. 2019 Jun 21;19(1):151. doi: 10.1186/s12872-019-1132-1.

Abstract

Background: Continuous-flow left ventricular assist devices (LVADs) improve survival and morbidity in patients with stage D heart failure. Management of LVADs for longer durations is necessary in some clinical settings, and a better understanding of the hemodynamics of patients using LVADs is warranted. Arrhythmia, including atrial (AA) and ventricular (VAs) arrhythmias, is a modifying factor of hemodynamics that is highly prevalent among patients with LVADs. However, the clinical impact of arrhythmias in various clinical settings in patients with LVAD, in which the hemodynamic load is likely to present as worsening of right heart failure, remains to be completely elucidated.

Case presentation: We describe the case of a patient under sustained ventricular fibrillation for extraordinarily long duration who was stabilized using LVAD support and in whom newly developed atrial fibrillation led to a significant worsening of right heart failure while using an LVAD.

Conclusion: This case demonstrates the substantial clinical impact of AAs in the management of right heart failure using an LVAD.

Keywords: Atrial fibrillation; Left ventricular assist device; Right heart failure; Ventricular fibrillation.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / physiopathology
  • Disease Progression
  • Heart Failure / complications
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Rate*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / instrumentation*
  • Ventricular Fibrillation / complications*
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / physiopathology
  • Ventricular Function, Left*
  • Ventricular Function, Right*