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Ventricular Assist Devices (VADs) which are a type of Mechanical Circulatory Support (MSC) Device are becoming more common in the treatment of ventricular atrophy. There have been longstanding questions about the viability of CPR on a patient with an VAD. Some providers are unsure what to do in the pursuit of resuscitation of a patient with an VAD.

Types of Mechanical Circulatory Support

MCS can support function of the left ventricle (LV) with a left VAD (LVAD), the right ventricle (RV) with a right VAD (RVAD), or both ventricles with a biventricular assist device. A total artificial heart (TAH) replaces the heart itself. Most patients who are discharged home with MCS currently have a durable LVAD. Thus, LVADs serve as the basis for most of these guidelines, although all current devices that may be encountered in the community are discussed.

Algorithm

The American Heart Association has published an algorithm (below) and a scholarly article on the Science of Resuscitation for LVAD patients.

AHA LVAD Algorithm. From: https://www.ahajournals.org/doi/10.1161/cir.0000000000000504

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