Association of pre-left ventricular assist device defibrillator shocks for ventricular arrhythmia with clinical outcomes after left ventricular assist device implantation.
Assist device
Defibrillation
Heart failure
Mechanical support
Ventricular tachycardia
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
medline:
30
11
2023
pubmed:
30
11
2023
entrez:
30
11
2023
Statut:
epublish
Résumé
Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks. The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy. Patients 18 years or older with continuous-flow LVADs and ICDs were retrospectively identified within the University of Pittsburgh Medical Center system from 2006-2020. We analyzed the association between appropriate ICD shocks within 1 year pre-LVAD with a primary composite outcome of death, stroke, and pump thrombosis and secondary outcomes of post-LVAD ICD shocks and ICD shock hospitalizations. Among 309 individuals, average age was 57 ± 12 years, 87% were male, 80% had ischemic cardiomyopathy, and 42% were bridge to transplantation. Seventy-one patients (23%) experienced pre-LVAD shocks, and 69 (22%) experienced post-LVAD shocks. The overall prevalence of shocks pre-LVAD and post-LVAD were not different. Pre-LVAD ICD shocks were not associated with the composite outcome. Pre-LVAD ICD shocks were found to predict post-LVAD shocks (hazard ratio [HR] 5.7; 95% confidence interval [CI] 3.42-9.48; Pre-LVAD ICD shocks predicted post-LVAD ICD shocks and hospitalizations but were not associated with the composite outcome of death, pump thrombosis, or stroke at 1 year. The prevalence of appropriate ICD shocks was similar before and after LVAD implantation in the entire cohort.
Sections du résumé
Background
UNASSIGNED
Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks.
Objectives
UNASSIGNED
The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy.
Methods
UNASSIGNED
Patients 18 years or older with continuous-flow LVADs and ICDs were retrospectively identified within the University of Pittsburgh Medical Center system from 2006-2020. We analyzed the association between appropriate ICD shocks within 1 year pre-LVAD with a primary composite outcome of death, stroke, and pump thrombosis and secondary outcomes of post-LVAD ICD shocks and ICD shock hospitalizations.
Results
UNASSIGNED
Among 309 individuals, average age was 57 ± 12 years, 87% were male, 80% had ischemic cardiomyopathy, and 42% were bridge to transplantation. Seventy-one patients (23%) experienced pre-LVAD shocks, and 69 (22%) experienced post-LVAD shocks. The overall prevalence of shocks pre-LVAD and post-LVAD were not different. Pre-LVAD ICD shocks were not associated with the composite outcome. Pre-LVAD ICD shocks were found to predict post-LVAD shocks (hazard ratio [HR] 5.7; 95% confidence interval [CI] 3.42-9.48;
Conclusion
UNASSIGNED
Pre-LVAD ICD shocks predicted post-LVAD ICD shocks and hospitalizations but were not associated with the composite outcome of death, pump thrombosis, or stroke at 1 year. The prevalence of appropriate ICD shocks was similar before and after LVAD implantation in the entire cohort.
Identifiants
pubmed: 38034894
doi: 10.1016/j.hroo.2023.10.002
pii: S2666-5018(23)00260-X
pmc: PMC10685166
doi:
Types de publication
Journal Article
Langues
eng
Pagination
708-714Informations de copyright
© 2023 Heart Rhythm Society. Published by Elsevier Inc.
Références
JACC Clin Electrophysiol. 2018 Sep;4(9):1166-1175
pubmed: 30236390
Circ Arrhythm Electrophysiol. 2013 Jun;6(3):648-54
pubmed: 23778248
Circulation. 2018 Dec 11;138(24):2841-2851
pubmed: 30565993
Artif Organs. 2020 Aug;44(8):E313-E325
pubmed: 32043582
ASAIO J. 2007 Mar-Apr;53(2):152-8
pubmed: 17413553
Heart Rhythm. 2017 Dec;14(12):1812-1819
pubmed: 28756099
Circulation. 2020 Mar 3;141(9):e139-e596
pubmed: 31992061
J Cardiovasc Electrophysiol. 2012 May;23(5):515-20
pubmed: 22081967
Cardiovasc Res. 1996 Jul;32(1):120-30
pubmed: 8776409
N Engl J Med. 2009 Dec 03;361(23):2241-51
pubmed: 19920051
Am J Cardiol. 2015 Nov 1;116(9):1385-90
pubmed: 26361826
J Interv Card Electrophysiol. 2019 Dec;56(3):341-348
pubmed: 31506872
J Thorac Dis. 2015 Dec;7(12):2158-64
pubmed: 26793336
JAMA Intern Med. 2013 May 27;173(10):859-65
pubmed: 23546173
J Heart Lung Transplant. 2010 Jul;29(7):771-6
pubmed: 20347337
Circ Arrhythm Electrophysiol. 2013 Aug;6(4):663-5
pubmed: 23962858
N Engl J Med. 2018 Apr 12;378(15):1386-1395
pubmed: 29526139
Heart Rhythm. 2010 Mar;7(3):353-60
pubmed: 20185109
JACC Clin Electrophysiol. 2018 Feb;4(2):257-264
pubmed: 29749947