A 58-year-old woman had medically refractory heart failure due to idiopathic dilated cardiomyopathy. She underwent tricuspid repair and left ventricular assist device implantation for inotropic-dependent heart failure. Because of severe right ventricular dysfunction, she experienced progressive bradycardia and ventricular asystole with electrocardiographic and echocardiographic standstill. Despite the lack of native cardiac activity, she maintained end-organ perfusion with inotropic support until she underwent successful transplantation. This report highlights a case of mechanical circulatory support with an isolated left ventricular assist device implantation even in the absence of native right ventricular function.
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