Impella-Induced Incessant Ventricular Tachycardia

Background: The Impella 2.5 and Impella Cardiac Power (CP) devices (ABIOMED) are used to provide mechanical circulatory support for high-risk percutaneous coronary interventions or cardiogenic shock as a bridge to recovery or destination therapy. The Impella device has shown both efficacy and safety in patients presenting with cardiogenic shock. Performing clinical and hemodynamic assessments of patients presenting with cardiogenic shock is an important step to determine if mechanical circulatory support with an Impella device is indicated. Case Report: A 62-year-old male presented with cardiogenic shock requiring Impella device support. Two days later, the patient developed incessant ventricular tachycardia. Transthoracic echocardiography showed that the Impella device had migrated out of the ventricular cavity. Once the position of the Impella device was adjusted, ventricular tachycardia immediately resolved. Conclusion: Our case emphasizes the importance of using imaging modalities such as transthoracic echocardiography to ensure correct positioning of an Impella device in the left ventricle to avoid complications.