Mechanically induced ventricular tachycardia by the HeartWare ventricular assist device

Fulminant myocarditis can lead to acute left ventricular dilatation and cardiogenic shock from heart failure. If hemodynamic stabilization cannot be achieved with maximized medical therapy, mechanical circulatory support becomes necessary. We here report on a 40-year-old patient who underwent emergent left ventricular assist device (LVAD) implantation (HVAD, HeartWare) in cardiogenic shock level 1 (Interagency Registry for Mechanically Assisted Circulatory Support). He quickly recovered and was fully active during follow-up. After 6 months, he first noticed palpitations and experienced episodes of dizziness, which were found to be caused by recurrent ventricular tachycardias. Echocardiography demonstrated a markedly remodeled and downsized left ventricle with improved function. A mechanical irritation of the HVAD inflow touching the inferior-posterior wall was found to trigger these focal arrhythmias. The HVAD was explanted, and no further arrhythmias occurred.