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Permanent pacing in a patient with a left ventricular assist system
M H Cave1, J Wallwork, P M Schofield
1Transplant Unit, Papworth Hospital, NHS Trust, Cambridge.
Heart (British Cardiac Society)
|May 1, 1996
Summary
Permanent Novacor left ventricular assist system implantation for end-stage heart failure led to right ventricular dysfunction. Atrioventricular pacing corrected heart block, resolving the dysfunction and improving device performance.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- End-stage heart failure necessitates advanced mechanical circulatory support.
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
- Novacor LVADs are used for long-term cardiac support.
Observation:
- A patient with end-stage heart failure received a Novacor LVAD.
- Postoperative progressive right ventricular dysfunction was observed.
- First-degree heart block developed during the early postoperative period.
Findings:
- Temporary and permanent atrioventricular pacing effectively managed the heart block.
- Pacing improved the performance of the Novacor LVAD.
- Right ventricular failure was sustainedly resolved following pacing.
Implications:
- Atrioventricular pacing can be a critical intervention for managing RV dysfunction post-LVAD.
- Optimizing AV synchrony is vital for LVAD performance and patient outcomes.
- This case highlights the importance of monitoring and managing RV function after LVAD implantation.