No Pulse, No Panic! Navigating Cardiac Arrest in LVAD-Supported Patients

The increasing use of left ventricular assist devices (LVADs) for advanced heart failure presents new challenges in emergency care, especially during cardiac arrest. LVAD-supported patients often lack palpable pulses and may have unreliable blood pressure readings, complicating diagnosis. Management strategies vary, with debates over whether to delay chest compressions to troubleshoot the device or initiate immediate resuscitation. Recognizing cardiac arrest involves alternative assessments like end-tidal co₂ and ultrasound. Limited evidence and inconsistent guidelines highlight the need for standardized protocols, training, and large registries to improve outcomes and guide best practices for prehospital and hospital management of LVAD patients experiencing cardiac emergencies.