Category: Central Venous Access Device

Pad Placement - LVAD Patients

Question#: 522

Question:

Good evening MedicASK,



In the PCP Entry to Practice formation for LVADs, it is said in the LVAD Presentation, Module 3-2b that anterior posterior defibrillator pad placement may not be indicated for LVAD patients. Yet in the LVAD video Part 2a, at the 14:30 minute mark, it is stated that anterior posterior defibrillator pad placement is best for treating arrhythmias. Question 5 of the LVAD quiz asks "_____ is the best pad placement for patients with an LVAD.", however I still am unclear on which pad placement is required for LVAD patients due to the contradicting information from the different presentations. Which defibrillator pad placement is best for LVAD patients, Anterior/Posterior or Anterior/Lateral? Thank you.



Best regards,

Spencer Thom

Answer:

Thank you for your question.

After consulting with the experts at the Heart Institute, they don't seem to have a preference for pad placement.

Having said that, the Anterior/Lateral (A/L) pad placement is mentioned as preferred as there's a risk of damaging the LVAD electronics that can be seen with Anterior/Posterior (A/P) placement.

As clinical situations and patient presentations can be different, we encourage you to start with A/L and assess for the need to move your pads A/P as changing vectors can be beneficial in some circumstances.

You can also consult with an LVAD coordinator to discuss a management plan for the specific patient care situation you encounter.

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