title: Arrhythmogenic right ventricular cardiomyopathy: use of a left ventricular assist device as a bridge to transplantation?
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.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 2269-1796 Summer Street, Halifax, NS, B3H 3A7, Canada, hani.mufti@dal.ca.
authors.forename: Hani N
authors.initials: HN
authors.lastname: Mufti
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Rajda
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Legare
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male