Key result
LVAD patient in VF demonstrates apparent organized contractility and rhythmic mitral valve opening on echo.
Why the study?
Ventricular arrhythmias remain highly prevalent in advanced heart failure, may impair continuous-flow left ventricular assist device support, and can lead to adverse clinical outcomes.
Case Report (n=1)
Echocardiography can be misleading in CF-LVAD patients, showing apparent organized contractility despite underlying ventricular fibrillation.
Echocardiography may mislead rhythm assessment in CF-LVAD patients; leaves open need for validated confirmation methods in device-supported hearts.
Sustained ventricular tachycardia and ventricular fibrillation (VF) are life-threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These ventricular arrhythmias may impair the support provided by continuous-flow left ventricular assist devices (CF-LVADs) and lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, and need for heart transplantation. We report a case in which a patient with a CF-LVAD and an implantable cardioverter defibrillator at end of life presented with asymptomatic low-flow alarms and was found to have VF of unknown duration. Unique in our case was the presence of apparent organized contractility and rhythmic opening of the mitral valve on echocardiogram despite VF on electrocardiogram.
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Singh et al. (2021) conducted a case report in Ventricular fibrillation in a patient with a continuous-flow left ventricular assist device (n=1). Echocardiogram vs. Electrocardiogram was evaluated. A patient with a continuous-flow left ventricular assist device in ventricular fibrillation demonstrated apparent organized contractility and rhythmic mitral valve opening on echocardiogram.
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