Stable Ventricular Fibrillation : A Paradigm Rather Than Septal Shift?
Copyright © ASAIO 2023..
Awake patients in ventricular fibrillation is a phenomenon limited to patients who are mechanically supported. We describe a cohort of patients supported by left ventricular assist devices (LVADs) presenting to the emergency department (ED) at a high-volume LVAD center while in awake ventricular fibrillation (VF)/ventricular tachycardia (VT). Among 175 patients reviewed, a total of 19 LVAD patients presented to the ED in awake VF/VT between December 2015 and July 2021. On ED presentation, patients maintained a median mean arterial blood pressure (MAP) of 70 mm Hg with a mean LVAD flow of 3.77 L/minute. ED management included cardioversion in the majority of cases: 58% were defibrillated once, 21% were defibrillated multiple times, 68% received amiodarone, and 21% received lidocaine. Inpatient management included defibrillation, ablation, and antiarrhythmic initiation in 37%, 11%, and 84% of cases, respectively. In total, five patients (26%) died with one death attributed to recurrent VT. Our findings support the short-term tolerability of sustained ventricular arrhythmias in LVAD patients, as evidenced by the maintained MAPs and mental status. Clinical teams, however, should be aware of the potential harbinger for in-hospital mortality heralded by an awake VF/VT presentation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:69 |
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| Enthalten in: |
ASAIO journal (American Society for Artificial Internal Organs : 1992) - 69(2023), 9 vom: 01. Sept., Seite 835-840 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bracy, Connor L [VerfasserIn] |
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| Anmerkungen: |
Date Completed 01.09.2023 Date Revised 04.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/MAT.0000000000001984 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361489420 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © ASAIO 2023. | ||
| 520 | |a Awake patients in ventricular fibrillation is a phenomenon limited to patients who are mechanically supported. We describe a cohort of patients supported by left ventricular assist devices (LVADs) presenting to the emergency department (ED) at a high-volume LVAD center while in awake ventricular fibrillation (VF)/ventricular tachycardia (VT). Among 175 patients reviewed, a total of 19 LVAD patients presented to the ED in awake VF/VT between December 2015 and July 2021. On ED presentation, patients maintained a median mean arterial blood pressure (MAP) of 70 mm Hg with a mean LVAD flow of 3.77 L/minute. ED management included cardioversion in the majority of cases: 58% were defibrillated once, 21% were defibrillated multiple times, 68% received amiodarone, and 21% received lidocaine. Inpatient management included defibrillation, ablation, and antiarrhythmic initiation in 37%, 11%, and 84% of cases, respectively. In total, five patients (26%) died with one death attributed to recurrent VT. Our findings support the short-term tolerability of sustained ventricular arrhythmias in LVAD patients, as evidenced by the maintained MAPs and mental status. Clinical teams, however, should be aware of the potential harbinger for in-hospital mortality heralded by an awake VF/VT presentation | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 7 | |a Lidocaine |2 NLM | |
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| 700 | 1 | |a Kobres, Pei-Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Hockstein, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Rao, Sriram D |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Richa |e verfasserin |4 aut | |
| 700 | 1 | |a Lam, Phillip H |e verfasserin |4 aut | |
| 700 | 1 | |a Sheikh, Farooq H |e verfasserin |4 aut | |
| 700 | 1 | |a Hockstein, Maxwell A |e verfasserin |4 aut | |
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