title: Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation.
abstract: BACKGROUND
  Early postoperative ventricular tachyarrhythmia (PoVT) after left ventricular assist device (LVAD) implantation are common and associated with higher mortality-rates. At present, there is no data on initiation of these PoVT and the role of alterations in cardiac hemodynamics.
  
  
  METHODS
  A LVAD was implanted in a patient with end-stage heart failure due to a ischemic cardiomyopathy. Alterations in cardiac rhythm and hemodynamics preceding PoVT-episodes during the first five postoperative days were examined by using continuous recordings of cardiac rhythm and various hemodynamic parameters. All PoVT (N=120) were monomorphic, most often preceded by short-long-short-sequences or regular SR and initiated by ventricular runs. Prior to PoVT, mean arterial pressure decreased; heart rate and ST-segments deviations increased.
  
  
  CONCLUSIONS
  PoVT are caused by different underlying electrophysiological mechanisms. Yet, they are all monomorphic and preceded by hemodynamic deterioration due to myocardial ischemia.
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Ameeta
authors.initials: A
authors.lastname: Yaksh
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Charles
authors.initials: C
authors.lastname: Kik
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Knops
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Korinne
authors.initials: K
authors.lastname: Zwiers
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Maarten J B
authors.initials: MJ
authors.lastname: van Ettinger
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Olivier C
authors.initials: OC
authors.lastname: Manintveld
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
authors.forename: Marcel C J
authors.initials: MC
authors.lastname: de Wijs
authors.affiliation: Sorin, Rotterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: van der Kemp
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.affiliation: Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, PO Box 616, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands. n.m.s.degroot@erasmusmc.nl.
authors.forename: Natasja M S
authors.initials: NM
authors.lastname: de Groot
mesh_terms: D009202:Cardiomyopathies / Q000150:complications; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology*
keywords: Continuous rhythm monitoring; Heartmate II; Hemodynamics; Ventricular tachycardia