Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 3 ( May-June, 2023 ) > List of Articles


A Rare Case Report: VA ECMO Support for Cardiogenic Shock Caused by Arrhythmia-induced Cardiomyopathy

Sanjay K Nihalani, Apoorva B Singhal, Gerasmos Capatos, Kalpana Krishnareddy, Seemin Shiraz, Anil Agarwal

Keywords : Atrial fibrillation, Cardiomyopathy, Extracorporeal membrane oxygenation

Citation Information : Nihalani SK, Singhal AB, Capatos G, Krishnareddy K, Shiraz S, Agarwal A. A Rare Case Report: VA ECMO Support for Cardiogenic Shock Caused by Arrhythmia-induced Cardiomyopathy. 2023; 2 (3):82-84.

DOI: 10.5005/jp-journals-11006-0059

License: CC BY-NC 4.0

Published Online: 26-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Herein we report a rare case of venoarterial extracorporeal membrane oxygenation (VA ECMO) support in a patient with arrhythmia-induced cardiomyopathy and cardiogenic shock. The patient had a lactate of more than 20 at the time of initiation of ECMO. Arrhythmia-induced cardiomyopathy is a potentially reversible state in which atrial or ventricular tachycardia/arrhythmias results in a decrease in left ventricular (LV) function, causing systolic heart failure and in rare cases, cardiogenic shock.1 VA ECMO is now increasingly used for various forms of cardiogenic shock, including the above condition that is unresponsive to conventional therapy. This is a case report of middle age man who presented with atrial fibrillation (AF) and rate related cardiomyopathy resulting in severe cardiogenic shock. He failed to respond to conventional management, including rate control medications, inotropic, and vasopressor agents. He had a cardiac arrest and was revived postcardiopulmonary resuscitation. Only with the early initiation of VA ECMO could the stabilization of hemodynamics be maintained. Further, ECMO support gave us the time for the reversible cardiomyopathy to resolve, and the patient survived who otherwise may not have in view of poor ejection fraction (EF) of 10%.

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