Annals of Emergency Medicine
Volume 57, Issue 1 , Pages 25-28, January 2011

Asymptomatic Sustained Ventricular Fibrillation in a Patient With Left Ventricular Assist Device

  • Mathias C. Busch, MD

      Affiliations

    • Department of Internal Medicine B, University of Greifswald, Greifswald, Germany
    • ,
  • Michael Haap, MD

      Affiliations

    • Department of Medicine, Division of Endocrinology, Diabetology, Nephrology and Vascular Medicine, University Hospital Tuebingen, Tuebingen, Germany
    • ,
  • Arnt Kristen, MD

      Affiliations

    • Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
    • ,
  • Christian S. Haas, MD

      Affiliations

    • Department of Medicine I, University Hospital Schleswig-Holstein, Luebeck, Germany
    • Corresponding Author InformationAddress for correspondence: Christian S. Haas, MD, University of Luebeck, Department of Medicine I, Ratzeburger Allee 160, 23538 Luebeck, Germany; 49-451-500-5060, fax 49-451-500-5066

Received 24 February 2009; received in revised form 15 February 2010 and 11 May 2010; accepted 18 May 2010. published online 05 August 2010.

Optimal medical treatment, cardiac resynchronization, and the use of an implantable cardioverter defibrillator are established therapies of severe congestive heart failure. In refractory cases, left ventricular assist devices are more and more used not only as bridging to cardiac transplantation but also as destination therapy. Ventricular arrhythmias may represent a life-threatening condition and often result in clinical deterioration in patients with congestive heart failure. We report a case of asymptomatic sustained ventricular fibrillation with preserved hemodynamics caused by a nonpulsatile left ventricular assist device. Consecutive adequate but unsuccessful discharges of the implantable cardioverter defibrillator were the only sign of the usually fatal arrhythmia, prompting the patient to consult emergency services. Electrolyte supplementation and initiation of therapy with amiodarone followed by external defibrillation resulted in successful restoration of a stable cardiac rhythm after 3.5 hours.

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 Supervising editor: Deborah B. Diercks, MD

 Reprints not available from the authors.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication dates: Available online July 31, 2010.

PII: S0196-0644(10)00495-6

doi:10.1016/j.annemergmed.2010.05.023

Annals of Emergency Medicine
Volume 57, Issue 1 , Pages 25-28, January 2011

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