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Orthostatic Hypotension in Patients With Left Ventricular Assist Devices: Acquired Autonomic Dysfunction

Fudim, Marat; Rogers, Joseph G.; Frazier-Mills, Camille; Patel, Chetan B.

doi: 10.1097/MAT.0000000000000640
Case Report: PDF Only

Contemporary left ventricular assist device (LVAD) technology uses nonphysiologic continuous flow to deliver blood into the circulation. This results in a reduction of pulsatility, which is implicated in some of the commonly associated side effects with LVAD therapy, including hypertension and gastrointestinal arterial-venous malformation with related bleeding. A less frequently observed side effect is orthostatic hypotension (OH) in patients supported with LVAD therapy. We present three cases of OH in patients with LVAD, followed by a discussion on how LVAD therapy may induce autonomic dysfunction.

From the Duke Cardiology, Duke University, Durham, North Carolina.

Submitted for consideration February 2017; accepted for publication in revised form May 2017.

M. Fudim is supported by an American Heart Association Grant, 17MCPRP33460225, and is a consultant for Coridea, AxonTherapies, and on the consulting board for GE Healthcare. J.G. Rogers has nothing to disclose. C. Frazier-Mills serves as a consultant to Boston Scientific. C.B. Patel serves as consultant to St. Jude Medical.

Correspondence: Marat Fudim, Duke University Medical Center, Durham, North Carolina. E-mail:

Copyright © 2018 by the American Society for Artificial Internal Organs