Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
Curr Opin Cardiol. 2020 May;35(3):289-294. doi: 10.1097/HCO.0000000000000730.
Left ventricular assist devices (LVADs) have extended the life expectancy of patients with heart failure. The hemodynamic support afforded by LVADs in this population has also resulted in patients having prolonged ventricular arrhythmias. The purpose of this article is to review the mechanisms of ventricular arrhythmias in LVADs and the available management strategies.
Recent evidence suggests that prolonged ventricular arrhythmias may result in increased mortality in patients with LVADs.
Successful management of ventricular arrhythmias in patients with LVAD requires interdisciplinary collaboration between electrophysiology and heart failure specialists. Medical management, including changes to LVAD changes, heart failure medication management, and antiarrhythmics constitute the initial treatment for ventricular arrhythmias. Surgical or endocardial ablation are reasonable options if VAs are refractory.
左心室辅助装置（LVAD）延长了心力衰竭患者的预期寿命。LVAD 在该人群中提供的血流动力学支持也导致患者出现延长的室性心律失常。本文的目的是回顾 LVAD 中室性心律失常的机制和现有的管理策略。
最近的证据表明，LVAD 患者的室性心律失常时间延长可能导致死亡率增加。
LVAD 患者室性心律失常的成功管理需要电生理学和心力衰竭专家之间的跨学科协作。医疗管理，包括 LVAD 变化、心力衰竭药物管理和抗心律失常药物的改变，构成了室性心律失常的初始治疗。如果室性心动过速仍然存在，可以选择手术或心内膜消融。
