Case Report Artificial Heart (Clinical)

Journal of Artificial Organs

, Volume 16, Issue 4, pp 498-500

First online:

Arrhythmogenic right ventricular cardiomyopathy: use of a left ventricular assist device as a bridge to transplantation?

  • Hani N. MuftiAffiliated withDivision of Cardiac Surgery, Department of Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie UniversityDepartment of Surgery, King Abdulaziz Medical City, National Guard Health Affairs
  • , Miroslaw RajdaAffiliated withDivision of Cardiology, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University
  • , Jean-Francois LegareAffiliated withDivision of Cardiac Surgery, Department of Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University Email author 

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Abstract

The principal characteristic of arrhythmogenic right ventricular cardiomyopathy (ARVC) is the tendency for ventricular arrhythmia and sudden death to occur without overt ventricular dysfunction. Current recommendations for management of patients with ARVC include insertion of an automated implantable cardioverter–defibrillator (AICD) to prevent sudden cardiac death. However, despite the use of AICD and/or anti-arrhythmic drugs some patients suffer recurrent ventricular arrhythmias unresponsive to optimum medical management. We present two cases of ARVC with refractory recurrent ventricular arrhythmias that were successfully managed by left ventricular assist device (LVAD) implantation, as a bridge to transplant (BTT). These two cases are unconventional examples of use of LVAD, given the predominant right ventricular pathology of ARVC and the arrhythmogenic nature of their presentation. The novelty of these cases should be taken in the context of increasing pressure to standardize indications for use of mechanical circulatory support.

Keywords

Ventricular assist device Arrhythmia Heart transplant Heart failure