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Suction events during left ventricular support and ventricular arrhythmias
Michael Vollkron1, Peter Voitl, Julia Ta
1Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria. michael.vollkron@meduniwien.ac.at <michael.vollkron@meduniwien.ac.at>
Summary
Suction events in rotary blood pumps can trigger severe ventricular arrhythmias, particularly ventricular tachycardia. These arrhythmias are transient, typically resolving within five minutes after the suction is cleared.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Axial blood pumps provide prolonged clinical support but lack inherent load-responsive mechanisms.
- Excessive ventricular unloading can occur during reduced venous return, potentially leading to adverse events.
- Ventricular arrhythmias linked to suction events in rotary blood pumps have not been previously described.
Purpose of the Study:
- To investigate the relationship between suction events and ventricular arrhythmias in patients receiving rotary blood pump support.
- To analyze electrocardiographic changes during ventricular collapse associated with automatic suction detection.
Main Methods:
- Analysis of clinical trial data focusing on electrocardiographic (ECG) changes during ventricular collapse.
- Utilized an automatic suction detection system to identify episodes of excessive unloading.
- Semi-manual classification of ECGs aided by a graphical interface and statistical analysis using Wilcoxon's signed-rank test.
Main Results:
- A significant increase in monomorphic ventricular tachycardia was observed after automatic suction detection (0.015 to 0.099 events/sec, p < 0.05).
- Morphologic ventricular tachycardia also increased following suction events (0.009 to 0.014 events/sec).
Conclusions:
- Excessive left ventricular unloading during continuous support can induce ventricular arrhythmias.
- Evidence supports an increase in arrhythmic activity post-suction, which is a transient effect.
- ECG events related to suction are characterized by sudden onset, severe ventricular arrhythmias, and typically cease after suction clearance.
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