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Reminder of important clinical lesson
Case report
Awake and aware with ongoing ventricular fibrillation during LVAD treatment: is it possible?
  1. Ingrid Hell Mott,
  2. Steen Hvitfeldt Poulsen and
  3. Brian Bridal Løgstrup
  1. Department of Cardiology, Aarhus University, Aarhus, Denmark
  1. Correspondence to Dr Brian Bridal Løgstrup; bbl{at}dadlnet.dk

Abstract

Left ventricular assist devices (LVADs) are currently used as destination therapy or bridge to heart transplantation in patients with advanced chronic heart failure (CHF). It has been proved to reduce mortality and symptoms in these patients. Patients with advanced CHF are known to have increased risk of ventricular arrhythmias (ventricular tachycardia or ventricular fibrillation (VF)) despite the presence of LVAD. We report the case of patients with ongoing VF during LVAD treatment while being awake and aware. We discuss the challenges introduced along with the increasing use of LVAD treatment. The decision whether a patient with LVAD automatically should have an implantable cardioverter-defibrillator is challenging. Randomised trials are warranted to shed light on these challenging decisions.

  • arrhythmias
  • heart failure
  • ischaemic heart disease

https://doi.org/10.1136/bcr-2020-234527

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    Footnotes

    • Contributors All authors, IHM, SHP and BBL have substantially contributed to all aspects for this case report. IHM, SHP and BBL were involved in the conception and design of the case report and performed acquisition of data. IHM, SHP and BBL were involved in the analysis and interpretation of clinical results. IHM and BBL performed the drafting of the manuscript. SHP involved in the critical revision of the manuscript for important intellectual content. IHM and BBL contributed equally to this work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.