Arrhythmias

Atrial Fibrillation

Common and may result in haemodynamic instability and like in normal patients may be well tolerated or result in haemodynamic instability

Ventricular arrhythmias: (VT and VF)

VT is common and again may be well tolerated. 

VF is often a terminal event but a small percentage of patients can tolerate it these patients may be alert and talking. 

Ventricular arrhythmias may be due to:

• Underlying scar
• Suction events (Mechanical sucking down of left ventricle from inflow cannula) related to reduced flow to LV such as in RV failure, hypovolaemia, elevated PA pressures
• Dilating RV

Ventricular arrhythmias are better tolerated in LVAD patients due to the physiological support provided by the VAD. 

Persistent arrhythmias or repeated RV fibrillation can compromise RV function remember the importance of RV function on VAD mechanics. 

Learning bite

The LVAD is only as good as your RV.