Tolerance of Sustained Ventricular Fibrillation During Left Ventricular Assist Device Support With IMPELLA CP®

A 64-year-old man was admitted with subacute anterior ST-segment elevation myocardial infarction treated with implantation of four drug-eluting stents in proximal left anterior descending artery. Despite successful percutaneous coronary intervention, the patient developed a significant worsening of left ventricular ejection fraction because of late diagnosis. A percutaneous mechanical circulatory support device (Impella CP; Abiomed) was then required in order to preserve adequate systemic perfusion. Twelve hours later, the patient developed rapid ventricular tachycardia degenerated in ventricular fibrillation, without loss of consciousness. During the arrhythmia, lasting for 10 min, the patientwas alert, with preserved mental status. After adequate sedation, a single unsynchronized 200 J DC shock converted the patient to sinus rhythm. (c) 2021 Elsevier Inc. All rights reserved.