Importance of ventricular arrhythmias in bridge patients with ventricular assist devices

To evaluate whether bridge to transplant patients with ventricular arrhythmias (VA; fibrillation or tachycardia) are at risk of death before or during ventricular assist device (VAD) support, the records of 28 patients who were supported with VADs for periods of 0.1 to 370 days (mean, 35.3 days) were retrospectively reviewed. VADs were effective in reducing the incidence of VA by 36%; however, patients with ischemic heart disease had a high incidence of VA (44%) during VAD. Only one patient with non-ischemic heart disease (8%) had VA during VAD. All five patients supported with left ventricular assist devices who had VA during support survived. Overall, the occurrence of VA during VAD was not a mortality risk. Since VAs are not predictors of survival, the presence of VA should not influence patient selection. While biventricular assist devices may be necessary in patients with the most severe VA, an LVAD provides excellent support in many patients.