Left ventricular assist devices (LVADs) are an increasingly used strategy for the management of patients with advanced heart failure. Although these devices effectively improve survival, atrial and ventricular arrhythmias are common with a prevalence of 20-50% at one year after LVAD implantation. Arrhythmias predispose these patients to additional risk and are associated with considerable morbidity from recurrent implantable cardioverter-defibrillator shocks, progressive failure of the unsupported right ventricle, and herald an increased risk of mortality. Management of patients with arrhythmias and LVAD differs in many aspects from the general population heart failure patients. These include ruling out the reversible causes of arrhythmias that in LVAD patients may include mechanical irritation from the inflow cannula and suction events. For patients with symptomatic arrhythmias refractory to medical treatment, catheter ablation might be relevant. There are specific technical and procedural challenges perceived to be unique to LVAD-related ventricular tachycardia (VT) ablation such as vascular and LV access, signal filtering, catheter manoeuvrability within decompressed chambers, and electroanatomic mapping system interference. In some patients, the arrhythmogenic substrate might not be readily accessible by catheter ablation after LVAD implantation. In this regard, the peri-implantation period offers a unique opportunity to surgically address arrhythmogenic substrate and suppress future VT recurrences. This document aims to address specific aspects of the management of arrhythmias in LVAD patients focusing on anti-arrhythmic drug therapy and ablations.

• Keywords
• Atrial fibrillation, Catheter ablation, Heart failure, Left ventricular assist device, Ventricular arrhythmia,
• MeSH
• Anti-Arrhythmia Agents * therapeutic use   MeSH
• Ventricular Function, Left MeSH
• Catheter Ablation * methods   MeSH
• Tachycardia, Ventricular therapy   surgery   physiopathology   MeSH
• Consensus MeSH
• Humans MeSH
• Heart-Assist Devices * MeSH
• Risk Factors MeSH
• Arrhythmias, Cardiac * therapy   physiopathology   diagnosis   MeSH
• Heart Failure * therapy   physiopathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Practice Guideline MeSH
• Geographicals
• Europe MeSH
• Names of Substances
• Anti-Arrhythmia Agents * MeSH