Cardiac arrhythmias in survivors of sudden cardiac death requiring impella assist device therapy

Khaled Q.A. Abdullah, Jana V. Roedler, Juergen Vom Dahl, Istvan Szendey, Dimitrios Dimitroulis, Lars Eckardt, Albert Topf, Bernhard Ohnewein, Lorenz Fritsch, Fabian Föttinger, Mathias C. Brandt, Bernhard Wernly, Lukas J. Motloch, Robert Larbig

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella assist device between 2008 and 2018. Rhythm monitoring is investigated in this population and associations with hospital survival are analyzed. Hospital mortality is high, at 83.5%. Diverse cardiac arrhythmias are frequently registered during Impella treatment. These include atrial fibrillation (AF, 21.1%) and ventricular tachycardia (VT, 18.3%), as well as AV block II /III (AVB, 7.3%), while intermittent asystole (ASY) is the most frequently observed arrhythmia (42.2%). Nevertheless, neither ventricular nor supraventricular tachycardias are associated with patients’ survival. In patients who experience intermittent asystole, a trend towards a fatal outcome is noted (p = 0.06). Conclusions: Mortality is high in these severely sick patients. While cardiac arrhythmias were frequent, they did not predict hospital mortality in this population. The hemodynamic support of the pump seems to counterbalance the adverse effects of these events.

Original languageEnglish
Article number1393
JournalJournal of Clinical Medicine
Volume10
Issue number7
DOIs
StatePublished - 1 Apr 2021
Externally publishedYes

Keywords

  • Arrhythmias
  • Assist devices
  • Asystole
  • Atrial fibrillation
  • Impella
  • Sudden cardiac death
  • Ventricular tachycar-dia

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