Ventricular Fibrillation in a Left Ventricular Assist Device Patient:
Can the echocardiogram be misleading?
Sustained ventricular tachycardia and ventricular fibrillation (VF) are
life-threatening arrhythmias which remain highly prevalent in patients
with advanced heart failure. These ventricular arrhythmias may impair
the support provided by CF-LVADs and lead to frequent hospitalizations,
antiarrhythmic medication use, external defibrillations, and need for
heart transplantation. We report a case in which a patient with a
CF-LVAD and an ICD at end-of-life (EOL) presented with asymptomatic
low-flow alarms and was found to have VF of unknown duration. Unique in
our case was the presence of organized contractility and rhythmic
opening of the mitral valve on echocardiogram despite VF on ECG.