Atrial arrhythmias in patients with left ventricular assist devices. (May 2020)

• Record Type: Journal Article
• Authors: Ozcan, Cevher; Deshmukh, Amrish
• Is Part Of: Current opinion in cardiology. Volume 35:Number 3(2020:May)
• Publication Date: 2020-05
• Subjects: atrial arrhythmias -- atrial fibrillation -- heart failure -- left ventricular assist devices; Cardiology -- Periodicals; Cardiology -- Periodicals; Heart Diseases -- Periodicals; Cardiology; Periodicals; 616.12
• DOI: 10.1097/HCO.0000000000000729
• Languages: English
• ISSNs: 0268-4705

Abstract

Abstract : Purpose of review: Atrial arrhythmias commonly occur in patients with advanced heart failure with reduced ejection fraction (HFrEF) who require left ventricular assist devices (LVADs) implantation. This review summarizes the current literature regarding the incidence, prevalence, and predictors of atrial arrhythmias in LVAD patients and its impact on the clinical outcomes. Moreover, we review the mechanisms and management strategies of atrial arrhythmias in this population. Recent findings: Atrial arrhythmias including atrial fibrillation, atrial flutter, and atrial tachycardia are highly prevalent in patients with advanced HFrEF before or after the LVAD implantation. Atrial arrhythmias have a significant impact on overall clinical outcome including survival, heart failure hospitalization, quality of life, thromboembolic events and resource utilization. Atrial fibrillation and other atrial arrhythmias frequently coexist in this population. In patients with atrial arrhythmias and LVAD, anticoagulation and cardiovascular implantable electronic devices should be closely monitored and managed to prevent thromboembolic events or inappropriate shocks. Rhythm and rate control strategies are comparable regarding overall clinical outcomes in this population. LVADs induce favorable atrial remodeling in patients with HFrEF. Summary: Atrial arrhythmias are highly common in LVAD patients and have significant impact on overall clinical outcomes. Further studies are needed to determine optimal management and prevention of atrial arrhythmias in LVAD population.