Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 31;10(7):1393.
doi: 10.3390/jcm10071393.

Cardiac Arrhythmias in Survivors of Sudden Cardiac Death Requiring Impella Assist Device Therapy

Khaled Q A Abdullah  1   2 , Jana V Roedler  1 , Juergen Vom Dahl  1 , Istvan Szendey  1 , Dimitrios Dimitroulis  1 , Lars Eckardt  3 , Albert Topf  4 , Bernhard Ohnewein  4 , Lorenz Fritsch  4 , Fabian Föttinger  4 , Mathias C Brandt  4 , Bernhard Wernly  4   5   6 , Lukas J Motloch  4 , Robert Larbig  2   3
Affiliations

Cardiac Arrhythmias in Survivors of Sudden Cardiac Death Requiring Impella Assist Device Therapy

Khaled Q A Abdullah et al. J Clin Med. .

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.

Keywords: Impella; arrhythmias; assist devices; asystole; atrial fibrillation; sudden cardiac death; ventricular tachycardia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Characteristics of cardiac arrhythmias in sudden cardiac death (SCD) survivors treated with an Impella: (a) incidence of sustained VT, (b) incidence of atrial fibrillation (AF), (c) incidence of higher degree AV block II°/III° (AVB) type, (d) incidence of asystole.
Figure 2
Figure 2
Incidence of cardiac arrhythmias in hospital death vs. survivors: (a) incidence of AF, (b) incidence of new-onset AF, (c) incidence of sustained VT, (d) incidence of asystole.
See this image and copyright information in PMC

References

    1. Zipes D.P., Wellens H.J. Sudden cardiac death. Circulation. 1998;98:2334–2351. doi: 10.1161/01.CIR.98.21.2334. - DOI - PubMed
    1. European Heart Rhythm Association. Heart Rhythm Society. Zipes D.P. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the american college of cardiology/american heart association task force and the European society of cardiology committee for practice guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol. 2006;48:e247–e346. - PubMed
    1. Lackermair K., Sattler S., Huber B.C. Retrospective analysis of circulatory support with the Impella CP(R) device in patients with therapy refractory cardiogenic shock. Int. J. Cardiol. 2016;219:200–203. doi: 10.1016/j.ijcard.2016.06.023. - DOI - PubMed
    1. Lemaire A., Anderson M.B., Lee L.Y. The Impella device for acute mechanical circulatory support in patients in cardiogenic shock. Ann. Thorac. Surg. 2014;97:133–138. doi: 10.1016/j.athoracsur.2013.07.053. - DOI - PubMed
    1. Dhruva S.S., Ross J.S., Mortazavi B.J. Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock. JAMA. 2020;323:734–745. doi: 10.1001/jama.2020.0254. - DOI - PMC - PubMed

LinkOut - more resources