Published in:
Open Access
01-12-2016 | Case report
Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation
Authors:
Ameeta Yaksh, Charles Kik, Paul Knops, Korinne Zwiers, Maarten J. B. van Ettinger, Olivier C. Manintveld, Marcel C. J. de Wijs, Peter van der Kemp, Ad J. J. C. Bogers, Natasja M. S. de Groot
Published in:
Journal of Cardiothoracic Surgery
|
Issue 1/2016
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Abstract
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.