Impact of Cardiac Resynchronization Therapy on Ventricular Arrhythmias and Survival After Durable Left Ventricular Assist Device Implantation.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
29 Jul 2024
29 Jul 2024
Historique:
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
29
7
2024
Statut:
aheadofprint
Résumé
The impact of cardiac resynchronization therapy (CRT) in patients receiving durable left ventricular assist device (LVAD) implantation remains unclear and there is no consensus regarding postoperative management. We sought to determine the impact of postoperative management of CRT on clinical outcomes following LVAD implantation. A total of 789 patients underwent LVAD implantation at our institution from 2007 to 2022 including 195 patients (24.7%) with preoperative CRT. Patients with preoperative CRT were significantly older and more frequently received an LVAD as destination therapy compared to patients without preoperative CRT. After LVAD implantation, 85 patients had CRT programmed "off" and 74 patients had CRT programmed "on." The risk of mortality was significantly increased amongst patients with preoperative CRT that was turned "on" following LVAD implantation compared to patients with preoperative CRT turned "off" following implant (subdistribution hazard ratio [sdHR] = 1.54; 1.06-2.37 95% confidence interval [CI]; p = 0.036). There was no significant difference between incidence of ventricular arrhythmias in patients with and without postoperative CRT "on" (35.1% vs. 48.2%; p = 0.095). Additional clinical trials are warranted to determine the best CRT programming strategy following LVAD implantation.
Identifiants
pubmed: 39074441
doi: 10.1097/MAT.0000000000002279
pii: 00002480-990000000-00532
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © ASAIO 2024.
Déclaration de conflit d'intérêts
Disclosure: F.H.S. has received institutional research support and honorarium for educational conferences from Abbott. The other authors have no conflicts of interest to report.
Références
Mehra MR, Uriel N, Naka Y; MOMENTUM 3 Investigators: A fully magnetically levitated left ventricular assist device. N Engl J Med 2019: 1618, 1627.
Mehra MR, Cleveland JC Jr, Uriel N; MOMENTUM 3 Investigators: Primary results of long-term outcomes in the MOMENTUM 3 pivotal trial and continued access protocol study phase: A study of 2200 HeartMate 3 left ventricular assist device implants. Eur J Heart Fail 2021: 1392, 1400.
Yuzefpolskaya M, Schroeder SE, Houston BA, et al.: The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on 2018 heart transplant allocation system. Ann Thorac Surg 115: 311–327, 2023.
Mehra MR, Goldstein DJ, Cleveland JC, et al.: Five-year outcomes in patients with fully magnetically levitated vs axial-flow left ventricular assist devices in the MOMENTUM 3 randomized trial. JAMA 328: 1233, 1242.
Hsich EM, Blackstone EH, Thuita LW, et al.: Heart transplantation: An in-depth survival analysis. JACC Heart Fail 8: 557–568, 2020.
Ali HR, Kiernan MS, Choudhary G, et al.: Right ventricular failure post-implantation of left ventricular assist device: Prevalence, pathophysiology, and predictors. ASAIO J 66: 610–619, 2020.
Abraham WT, Fisher WG, Smith AL, et al.; MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation: Cardiac resynchronization in chronic heart failure. N Engl J Med 346: 1845–1853, 2002.
Bristow MR, Saxon LA, Boehmer J, et al.; Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators: Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350: 2140–2150, 2004.
Cleland JG, Daubert JC, Erdmann E, et al.; Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators: The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352: 1539–1549, 2005.
Barsheshet A, Wang PJ, Moss AJ, et al.: Reverse remodeling and the risk of ventricular tachyarrhythmias in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy). J Am Coll Cardiol 57: 2416–2423, 2001.
Lindenfeld J, Feldman AM, Saxon L, et al.: Effects of cardiac resynchronization therapy with or without a defibrillator on survival and hospitalizations in patients with New York Heart Association class IV heart failure. Circulation 115: 204–212, 2007.
Cotarlan V, Johnson F, Goerbig-Campbell J, et al.: Usefulness of cardiac resynchronization therapy in patients with continuous flow left ventricular assist devices. Am J Cardiol 123: 93–99, 2019.
Tomashitis B, Balcu CF, Butschek RA, et al.: Acute hemodynamic effects of cardiac resynchronization therapy versus alternative pacing strategies in patients with left ventricular assist devices. J Am Heart Assoc 10: e018127, 2021.
Chung BB, Grinstein JS, Imamura T, et al.: Biventricular pacing versus right ventricular pacing in patients supported with LVAD. JACC Clin Electrophysiol 7: 1003–1009, 2021.
Richardson TD, Hale L, Arteaga C, et al.: Prospective randomized evaluation of implantable cardioverter-defibrillator programming in patients with a left ventricular assist device. J Am Heart Assoc 7: e007748, 2018.
Roukoz H, Bhan A, Ravichandran A, et al.: Continued versus suspended cardiac resynchronization therapy after left ventricular assist device implantation. Sci Rep 10: 2573, 2020.
Gopinathannair R, Roukoz H, Bhan A, et al.: Cardiac resynchronization therapy and clinical outcomes in continuous flow left ventricular assist device recipients. J Am Heart Assoc 7: e009091, 2018.
Gopinathannair R, Birks EJ, Trivedi JR, et al.: Impact of cardiac resynchronization therapy on clinical outcomes in patients with continuous-flow left ventricular assist devices. J Card Fail 21: 226–232, 2015.
Chou A, Larson J, Deshmukh A, et al.: Association between biventricular pacing and incidence of ventricular arrhythmias in the early post-operative period after left ventricular assist device implantation. J Cardiovasc Electrophysiol 33: 1024–1031, 2022.
Schleifer JW, Mookadam F, Kransdorf EP, et al.: Effect of continued cardiac resynchronization therapy on ventricular arrhythmias after left ventricular assist device implantation. Am J Cardiol 118: 556–559, 2016.
Parikh V, Sauer A, Friedman PA, Sheldon SH: Management of cardiac implantable electronic devices in the presence of left ventricular assist devices. Heart Rhythm 15: 1089–1096, 2018.
Ravichandran A, Pothineni NVK, Trivedi JR, et al.: Implantable cardioverter-defibrillator-related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience. Heart Rhythm O2 2: 691–697, 2021.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ 335: 806–808, 2007.
Molina EJ, Shah P, Kiernan MS, et al.: The Society of Thoracic Surgeons Intermacs 2020 Annual Report. Ann Thorac Surg 111: 778–792, 2021.
Bleeker GB, Schalij MJ, Nihoyannopoulos P, et al.: Left ventricular dyssynchrony predicts right ventricular remodeling after cardiac resynchronization therapy. J Am Coll Cardiol 46: 2264–2269, 2005.
Campbell P, Takeuchi M, Bourgoun M, et al.; Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) Investigators: Right ventricular function, pulmonary pressure estimation, and clinical outcomes in cardiac resynchronization therapy. Circ Heart Fail 6: 435–442, 2013.
Rickard J, Gold MR, Patel D, et al.: Long-term outcomes in nonprogressors to cardiac resynchronization therapy. Heart Rhythm 20: 165–170, 2022.
Ouellet G, Huang DT, Moss AJ, et al.: Effect of cardiac resynchronization therapy on the risk of first and recurrent ventricular tachyarrhythmic events in MADIT-CRT. J Am Coll Cardiol 60: 1809–1816, 2012.
Ruwald MH, Solomon SD, Foster E, et al.: Left ventricular ejection fraction normalization in cardiac resynchronization therapy and risk of ventricular arrhythmias and clinical outcomes: Results from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) trial. Circulation 130: 2278–2286, 2014.
Gold MR, Linde C, Abraham WT, Gardiwal A, Daubert J-C: The impact of cardiac resynchronization therapy on the incidence of ventricular arrhythmias in mild heart failure. Heart Rhythm 8: 679–684, 2011.
Thibault B, Harel F, Ducharme A, et al.; LESSER-EARTH Investigators: Cardiac resynchronization therapy in patients with heart failure and a QRS complex <120 milliseconds: The Evaluation of Resynchronization Therapy for Heart Failure (LESSER-EARTH) trial. Circulation 127: 873–881, 2013.
Ruschitzka F, Abraham WT, Singh JP, et al.; EchoCRT Study Group: Cardiac-resynchronization therapy in heart failure with a narrow QRS complex. N Engl J Med 369: 1395–1405, 2013.
Reesink K, Dekker A, Van der Nagel T, et al.: Suction due to left ventricular assist: Implications for device control and management. Artif Organs 31: 542–549, 2007.
Gross C, Schima H, Schlöglhofer T, et al.: Continuous LVAD monitoring reveals high suction rates in clinically stable outpatients. Artif Organs 44: 251–262, 2020.
Gilge JL, Sbircea N, Tong MZ, et al.: Incidence of cardiac implantable electronic device complications in patients with left ventricular assist devices. JACC Clin Electrophysiol 7: 494–501, 2021.