Left ventricular assist devices (LVADs) are implanted for patients with advanced heart failure. LVADs can be used as a temporary solution for patients eligible and awaiting heart transplantation (Bridge-to-Transplant) or as a permanent treatment (Destination Therapy). Since the LVAD only treats the left side of the heart, a possible limitation with LVAD use can be the early or late onset of right ventricular insufficiency. Multiple factors may affect this. While an LVAD improves cardiac output, the decrease in left ventricular pressure can shift the wall between the ventricles (interventricular septum) to the left, leading to enlargement of the right ventricle and possibly an increase leak of the tricuspid valve that is tethered to the inner walls of the right ventricle. In most patients, right ventricular failure does not occur because the lowering of the left heart pressures leads to a lower pressure that the right ventricle has to pump against in the pulmonary artery.

I am sorry to hear of your fathers condition. The medication your father is taking is most likely a medication drip which contains Sodium Chloride but not sodium chloride alone. I recommend reviewing our Treatment section, researching new heart failure medications such as, Ivabridine or Entresto, and speaking with your fathers doctor on available options in your area.

You pose a good question. Previous studies such as that by Dr. Psaty, “Incidence of and Risk Factors for Atrial Fibrillation in Older Adults”, have shown an increased risk for persistent atrial fibrillation in patients with increased left atrial size frequently resulting in worsening of symptoms. It is important to speak with your doctor about anticoagulation, Xa inhibitors, and/or direct thrombin inhibitors to reduce the risk of  blood clots and stroke.

An increased heart rate over 100 is considered a tachycardia. In most patients, high rates cause patients to become symptomatic. This occurs because an increased heart rate does not allow the heart enough time to fill with blood and in turn reduces the amount of blood pumped into the body. When the top portion of the heart, known as the atrium has a very high rate this can result from conditions such as supraventricular tachycardia, atrial flutter, and/or atrial fibrillation. This can result in symptoms such as shortness of breath, palpitations, weakness, chest discomfort, and an increased risk of blood clots. These arrhythmia’s usually can be treated with medication and/or cardiac procedures.

A sustained fast heart rate in the lower portion of the heart, the ventricles, can be life threatening due to the fact that the bottom portion of the heart is critical in pumping oxygenated blood to the body. Ventricular arrhythmias may also cause dizziness, palpitations, chest pain, nausea, and shortness of breath.

I always recommend seeing your cardiologist for advice regarding your health.  In regards to The NYHA functional class, it can wax and wane depending on symptoms. Class I is defined as having no limitation with activity. Left Bundle Branch Block (LBBB) is associated with Dilated Cardiomyopathy (DCM) but it is unknown whether it causes the LV dilation or the LV dilation causes the LBBB. Studies have found that patients with low ejection fraction and LBBB are more likely to have a nonischemic etiology (not caused by blocked arteries) compared to those that do not have conduction issues. Lisinopril can help heart failure independent of lowering blood pressure. It seems like you are on appropriate medications