Document Detail


Prolonged repolarization after ventricular assist device support is associated with arrhythmias in humans with congestive heart failure.
MedLine Citation:
PMID:  15812752     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent observations indicate that the QTc interval often increases in the early postoperative period (<1 week) after mechanical unloading of severely failing hearts with a left ventricular assist device (LVAD). The present study examined whether early changes in ventricular repolarization after LVAD placement are associated with ventricular arrhythmias. METHODS AND RESULTS: An electrocardiogram was obtained within 4 days before LVAD placement, <12 hours after LVAD placement, and weekly thereafter. Patient records were reviewed for documented ventricular tachycardia (VT) or ventricular fibrillation (VF) for 1 week preoperatively and the first 2 weeks postoperatively. Differences in QTc interval between patients with and without VT were evaluated. Ten of 17 patients enrolled (59%) had VT or VF after LVAD placement. Of these, 4 required therapeutic intervention because of clinical instability or symptoms. The change in the QTc (DeltaQTc) between the preoperative and immediate postoperative period was significantly different among patients with VT/VF compared with patients without VT/VF (+23 ms vs. -68 ms, P < .001). CONCLUSION: The early period after initiation of LVAD support of the failing human heart is associated with a relatively high incidence of significant ventricular arrhythmias after LVAD placement. Beyond the impact of myocardial inflammation and wound healing occurring after all LVAD implants, early postoperative increases in the QTc interval after cardiac unloading appear to predispose to ventricular arrhythmias.
Authors:
John D Harding; Valentino Piacentino; Steven Rothman; Susan Chambers; Mariell Jessup; Kenneth B Margulies
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  11     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-06     Completed Date:  2005-09-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  227-32     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia, PA 19140, USA.
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MeSH Terms
Descriptor/Qualifier:
Electrocardiography
Female
Heart Failure / surgery*
Heart-Assist Devices*
Humans
Male
Postoperative Complications*
Retrospective Studies
Tachycardia, Ventricular / etiology*
Telemetry
Ventricular Dysfunction, Left / surgery
Ventricular Fibrillation / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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