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Title:           Drug therapy and catheter ablation for management of arrhythmias in continuous flow left ventricular assist device’s patients: a Clinical Consensus Statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC
Subject:         DOI: 10.1093/europace/euae272; Europace, 2024-10-31.; Abstract: Left ventricular assist devices (LVADs) are an increasingly used strategy for the management of patients with advanced heart failure. Although these devices effectively improve survival, atrial and ventricular arrhythmias are common with a prevalence of 20–50% at one year after LVAD implantation. Arrhythmias predispose these patients to additional risk and are associated with considerable morbidity from recurrent implantable cardioverter-defibrillator shocks, progressive failure of the unsupported right ventricle, and herald an increased risk of mortality. Management of patients with arrhythmias and LVAD differs in many aspects from the general population heart failure patients. These include ruling out the reversible causes of arrhythmias that in LVAD patients may include mechanical irritation from the inflow cannula and suction events. For patients with symptomatic arrhythmias refractory to medical treatment, catheter ablation might be relevant. There are specific technical and procedural challenges perceived to be unique to LVAD-related ventricular tachycardia (VT) ablation such as vascular and LV access, signal filtering, catheter manoeuvrability within decompressed chambers, and electroanatomic mapping system interference. In some patients, the arrhythmogenic substrate might not be readily accessible by catheter ablation after LVAD implantation. In this regard, the peri-implantation period offers a unique opportunity to surgically address arrhythmogenic substrate and suppress future VT recurrences. This document aims to address specific aspects of the management of arrhythmias in LVAD patients focusing on anti-arrhythmic drug therapy and ablations.
Keywords:        Left ventricular assist device; Atrial fibrillation; Ventricular arrhythmia; Catheter ablation; Heart failure
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      Title: Drug therapy and catheter ablation for management of arrhythmias in continuous flow left ventricular assist device’s patients: a Clinical Consensus Statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC
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        Title: Introduction
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        Title: Aim of the paper
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        Title: General considerations
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        Title: Drug therapy for arrhythmias in LVAD patients
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          Title: HF guideline-directed medical therapy
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         Item: 
          Title: AAD therapy
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         Item: 
          Title: Atrial arrhythmias
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          Title: Ventricular Arrhythmias
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          Title: Amiodarone use in post-LVAD arrhythmias
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        Title: Catheter ablation in LVAD recipients
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          Title: Catheter ablation of atrial arrhythmias
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          Title: Catheter ablation of VAs prior to LVAD implantation
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          Title: Peri-implantation surgical VAs ablation
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          Title: Catheter ablation of VAs after LVAD implantation
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          Title: Management of ES the role of drug therapy and catheter ablation
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        Title: Procedural aspects of catheter ablation in LVAD patients
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          Title: Pre- and peri-procedural imaging
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          Title: Signal filtering and the role of ECG in the location of the VT exit site
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          Title: EMI and selection of mapping system
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          Title: Mapping strategies and ablation targets
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          Title: Complications of catheter ablation in LVAD patients
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          Title: Vascular cannulation and access to cardiac chambers
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          Title: Peri-procedural haemodynamic monitoring
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        Title: Gaps in knowledge
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   Type: CRC32
  Checksum: 1063556a6fb1697ad83ea07d40c3074f
   Type: MD5
  Checksum: 2f16746aaa7cf15b3b0aa455a43214e4187c76d4
   Type: SHA-1
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   Type: SHA-256