When Should the Electrophysiologist Be Involved in Managing Patients with Ventricular Assist Devices and Ventricular Arrhythmias?

The successful management of ventricular arrhythmias (VAs) in people with left ventricular assist devices (LVADs) is often complex. The need for and the role of defibrillator therapy is continually evolving in this group. VAs occur frequently and significantly impact the clinical course of patients with LVADs. The management of VAs begins prior to LVAD implantation and typically involves appropriate implantable cardioverter-defibrillator use and programming after the fact. Surgical ablation during LVAD implantation and supplementary catheter ablation performed as needed are attractive options for the management of VAs in this population. The performance of catheter ablation is generally safe and feasible after LVAD implantation with a team approach.