{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:47:23Z","timestamp":1784209643034,"version":"3.55.0"},"reference-count":69,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Ventricular arrhythmias (VAs) are common and clinically important complications in patients supported by left ventricular assist devices (LVADs), occurring in up to 50% of cases within the first year after implantation. Despite the hemodynamic support provided by LVADs, VAs are linked to increased morbidity and mortality, primarily through recurrent implantable cardioverter defibrillator (ICD) shocks and right ventricular failure. The underlying mechanisms of VAs in this population are multifactorial, involving structural myocardial remodeling, device-related factors, and pre-existing arrhythmic substrates. Catheter ablation has become a valuable treatment option when antiarrhythmic drug therapy and device reprogramming are inadequate, though procedural timing (pre-, intra-, or post-implantation) and approaches remain under discussion. Epicardial access during LVAD surgery may provide advantages for selected patients, while ablation after implantation poses technical challenges due to altered anatomy and electromagnetic interference. This review offers a comprehensive overview of the epidemiology, pathophysiology, risk stratification, and management of VAs in LVAD recipients, emphasizing technical considerations, procedural safety, and clinical outcomes of catheter ablation. A multidisciplinary approach remains essential in guiding personalized treatment and optimizing outcomes for this complex population. Undergoing studies will provide more insight into optimal management of arrhythmias, particularly regarding the optimal timing of catheter ablation. The impact of new technologies such as non-invasive mapping alongside pre-procedural imaging needs also to be further evaluated.<\/jats:p>","DOI":"10.3390\/jcm14186604","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T12:33:32Z","timestamp":1758285212000},"page":"6604","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of Ventricular Arrhythmias in Patients with Left Ventricular Assist Devices: Pathophysiology, Risk Stratification, and Ablation Strategies"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6003-6054","authenticated-orcid":false,"given":"Giuseppe","family":"Sgarito","sequence":"first","affiliation":[{"name":"IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Campo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Sciacca","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Pilato","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0632-0561","authenticated-orcid":false,"given":"Manlio","family":"Cipriani","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6683-6781","authenticated-orcid":false,"given":"Sergio","family":"Conti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, The Carver College of Medicine, University of Iowa Health Care Center, University of Iowa, Iowa, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1002\/ehf2.13859","article-title":"Advanced heart failure: Guideline-directed medical therapy, diuretics, inotropes, and palliative care","volume":"9","author":"Tomasoni","year":"2022","journal-title":"ESC Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"euae272","DOI":"10.1093\/europace\/euae272","article-title":"Drug therapy and catheter ablation for management of arrhythmias in continuous flow left ventricular assist device\u2019s patients: A Clinical Consensus Statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC","volume":"26","author":"Peichl","year":"2024","journal-title":"Europace"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/j.1540-8191.2012.01504.x","article-title":"The spectrum of complications following left ventricular assist device placement","volume":"27","author":"Yuan","year":"2012","journal-title":"J. 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