Arrhythmias in children with ventricular assist devices

Cardiol Young. 2015 Feb;25(2):255-60. doi: 10.1017/S1047951113002126.


Background: Children with decompensated heart failure are at high risk for arrhythmias, and ventricular assist device placement is becoming a more common treatment strategy. The impact of ventricular assist devices on arrhythmias and how arrhythmias affect the clinical course of this population are not well described.

Methods and results: A single-centre retrospective analysis of children receiving a ventricular assist device between 1998 and 2011 was performed. In all, 45 patients received 56 ventricular assist devices. The median age at initial placement was 13 years (interquartile range 6-15). The median duration of support was 10 days (range 2-260). The aetiology of heart failure included cardiomyopathy, transplant rejection, myocarditis, and congenital heart disease. In all, 32 patients (71%) had an arrhythmia; 19 patients (42%) had an arrhythmia before ventricular assist device and eight patients (18%) developed new arrhythmias on ventricular assist device. Ventricular tachycardia was most common (25/32, 78%). There was no correlation between arrhythmia and risk of death or transplantation (p=0.14). Of the 15 patients who weaned from ventricular assist device, post-ventricular assist device arrhythmias occurred in nine (60%), with five (33%) having their first arrhythmia after weaning. Patients with ventricular dysfunction after ventricular assist device were more likely to have arrhythmias (p<0.02).

Conclusions: Arrhythmias, especially ventricular, are common in children requiring ventricular assist device. They frequently persist for those able to wean from ventricular assist device.

Keywords: heart failure.

MeSH terms

  • Adolescent
  • Arrhythmias, Cardiac
  • Cardiomyopathies / complications
  • Child
  • Female
  • Graft Rejection / complications
  • Heart Defects, Congenital / complications
  • Heart Failure / etiology
  • Heart Failure / therapy*
  • Heart Transplantation
  • Heart-Assist Devices*
  • Humans
  • Male
  • Myocarditis / complications
  • Retrospective Studies
  • Tachycardia, Ventricular / epidemiology*
  • Ventricular Dysfunction / etiology
  • Ventricular Dysfunction / therapy*