PMC:6640909 / 114347-116322 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6640909","sourcedb":"PMC","sourceid":"6640909","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6640909","text":"17.5 Arrhythmia\n\nBackground\nArrhythmias are frequent during LT-MCS and a common cause of hospitalization. Ventricular and atrial arrhythmias are often a manifestation of the underlying disease and frequently present preoperatively. Several precipitating factors contribute to early postoperative arrhythmia [435].\n\nDescription of the evidence\nThe burden of VA in LT-MCS recipients is high; preoperative VA is the major predictor of late postoperative VA. VA is reasonably tolerated by many patients supported by LT-MCS with a low risk of immediate haemodynamic collapse [436]. The role of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death is unclear in patients supported by LT-MCS [84, 437]. Definitive data are not available: The largest retrospective study included mostly pulsatile devices, and the conclusions are not directly translatable to CF-LVAD [438]. For a subgroup of patients who present with a history of refractory VAs, aggressive antiarrhythmic therapy and catheter ablation are indicated.\nAtrial fibrillation is also common in patients with LT-MCS. The effect on outcome and risk of thromboembolism is relevant. Pharmacological rhythm control strategy is widely accepted; other procedures (catheter ablation, left appendage closure) have limited evidence. Pharmacological treatment is indicated, and catheter ablation may be attempted in cases of sustained or recurrent VA. In patients with an ICD implanted prior to LT-MCS implantation, ventricular tachycardia therapy should be active to prevent adverse sequelae of right ventricular dysfunction. However, ICD settings should be very conservative. Less evidence exists for primary prevention ICD in patients without arrhythmia at the time of LVAD implantation. It might be considered not to replace a depleted ICD battery in the absence of VAs. ICD implantation is indicated for patients with LT-MCS who develop postoperative VA with haemodynamic deterioration.","divisions":[{"label":"title","span":{"begin":0,"end":15}},{"label":"sec","span":{"begin":17,"end":313}},{"label":"title","span":{"begin":17,"end":27}},{"label":"p","span":{"begin":28,"end":313}},{"label":"title","span":{"begin":315,"end":342}},{"label":"p","span":{"begin":343,"end":1050}}],"tracks":[{"project":"TEST0","denotations":[{"id":"31100109-76-83-7775","span":{"begin":308,"end":311},"obj":"[\"26212658\"]"},{"id":"31100109-116-123-7776","span":{"begin":571,"end":574},"obj":"[\"29259511\"]"},{"id":"31100109-150-156-7777","span":{"begin":727,"end":729},"obj":"[\"29191299\"]"},{"id":"31100109-154-161-7778","span":{"begin":731,"end":734},"obj":"[\"23643502\"]"},{"id":"31100109-164-171-7779","span":{"begin":901,"end":904},"obj":"[\"20178869\"]"}],"attributes":[{"subj":"31100109-76-83-7775","pred":"source","obj":"TEST0"},{"subj":"31100109-116-123-7776","pred":"source","obj":"TEST0"},{"subj":"31100109-150-156-7777","pred":"source","obj":"TEST0"},{"subj":"31100109-154-161-7778","pred":"source","obj":"TEST0"},{"subj":"31100109-164-171-7779","pred":"source","obj":"TEST0"}]},{"project":"MyTest","denotations":[{"id":"31100109-26212658-28905835","span":{"begin":308,"end":311},"obj":"26212658"},{"id":"31100109-29259511-28905836","span":{"begin":571,"end":574},"obj":"29259511"},{"id":"31100109-29191299-28905837","span":{"begin":727,"end":729},"obj":"29191299"},{"id":"31100109-23643502-28905838","span":{"begin":731,"end":734},"obj":"23643502"},{"id":"31100109-20178869-28905839","span":{"begin":901,"end":904},"obj":"20178869"}],"namespaces":[{"prefix":"_base","uri":"https://www.uniprot.org/uniprot/testbase"},{"prefix":"UniProtKB","uri":"https://www.uniprot.org/uniprot/"},{"prefix":"uniprot","uri":"https://www.uniprot.org/uniprotkb/"}],"attributes":[{"subj":"31100109-26212658-28905835","pred":"source","obj":"MyTest"},{"subj":"31100109-29259511-28905836","pred":"source","obj":"MyTest"},{"subj":"31100109-29191299-28905837","pred":"source","obj":"MyTest"},{"subj":"31100109-23643502-28905838","pred":"source","obj":"MyTest"},{"subj":"31100109-20178869-28905839","pred":"source","obj":"MyTest"}]},{"project":"0_colil","denotations":[{"id":"31100109-26212658-7775","span":{"begin":308,"end":311},"obj":"26212658"},{"id":"31100109-29259511-7776","span":{"begin":571,"end":574},"obj":"29259511"},{"id":"31100109-29191299-7777","span":{"begin":727,"end":729},"obj":"29191299"},{"id":"31100109-23643502-7778","span":{"begin":731,"end":734},"obj":"23643502"},{"id":"31100109-20178869-7779","span":{"begin":901,"end":904},"obj":"20178869"}],"attributes":[{"subj":"31100109-26212658-7775","pred":"source","obj":"0_colil"},{"subj":"31100109-29259511-7776","pred":"source","obj":"0_colil"},{"subj":"31100109-29191299-7777","pred":"source","obj":"0_colil"},{"subj":"31100109-23643502-7778","pred":"source","obj":"0_colil"},{"subj":"31100109-20178869-7779","pred":"source","obj":"0_colil"}]},{"project":"2_test","denotations":[{"id":"31100109-26212658-28905835","span":{"begin":308,"end":311},"obj":"26212658"},{"id":"31100109-29259511-28905836","span":{"begin":571,"end":574},"obj":"29259511"},{"id":"31100109-29191299-28905837","span":{"begin":727,"end":729},"obj":"29191299"},{"id":"31100109-23643502-28905838","span":{"begin":731,"end":734},"obj":"23643502"},{"id":"31100109-20178869-28905839","span":{"begin":901,"end":904},"obj":"20178869"}],"attributes":[{"subj":"31100109-26212658-28905835","pred":"source","obj":"2_test"},{"subj":"31100109-29259511-28905836","pred":"source","obj":"2_test"},{"subj":"31100109-29191299-28905837","pred":"source","obj":"2_test"},{"subj":"31100109-23643502-28905838","pred":"source","obj":"2_test"},{"subj":"31100109-20178869-28905839","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"TEST0","color":"#ec93b0","default":true},{"id":"MyTest","color":"#93caec"},{"id":"0_colil","color":"#e4ec93"},{"id":"2_test","color":"#da93ec"}]}]}}