Journal article
Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality
JACC. Clinical electrophysiology, Vol.5(8), pp.944-954
08/2019
DOI: 10.1016/j.jacep.2019.05.025
PMID: 31439296
Abstract
This study aimed to evaluate incidence, clinical significance, and predictors of early ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients.
LVAD implantation is increasingly used in patients with end-stage heart failure. Early VAs may occur during the 30-day post-operative period, but many questions remain unanswered regarding their incidence and clinical impact.
This observational study was conducted in 19 centers between 2006 and 2016. Early VAs were defined as sustained ventricular tachycardia and/or ventricular fibrillation occurring <30 days post-LVAD implantation and requiring appropriate implantable cardioverter-defibrillator therapy, external electrical shock, or medical therapy.
A total of 652 patients (median age: 59.8 years; left ventricular ejection fraction: 20.7 ± 7.4%; HeartMate 2: 72.8%; HeartWare: 19.5%; Jarvik 2000: 7.7%) were included in the analysis. Early VAs occurred in 162 patients (24.8%), most frequently during the first week after LVAD implantation. Multivariable analysis identified history of VAs prior to LVAD and any combined surgery with LVAD as 2 predictors of early VAs. The occurrence of early VAs with electrical storm was the strongest predictor of 30-day post-operative mortality, associated with a 7-fold increase of 30-day mortality. However, in patients discharged alive from hospital, occurrence of early VAs did not influence long-term survival.
Early VAs are common after LVAD implantation and increase 30-day post-operative mortality, without affecting long-term survival. Further studies will be needed to analyze whether pre- or pre-operative ablation of VAs may improve post-operative outcomes. (Determination of Risk Factors of Ventricular Arrhythmias After Implantation of Continuous Flow Left Ventricular Assist Device With Continuous Flow Left Ventricular Assist Device [ASSIST-ICD]; NCT02873169)
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Details
- Title: Subtitle
- Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality
- Creators
- Vincent Galand - Laboratoire Traitement du Signal et de l'ImageErwan Flécher - Laboratoire Traitement du Signal et de l'ImageVincent Auffret - Laboratoire Traitement du Signal et de l'ImageCamille Pichard - Laboratoire Traitement du Signal et de l'ImageStéphane Boulé - Centre Hospitalier Universitaire de LilleAndré Vincentelli - Centre Hospitalier Universitaire de LilleAnne Rollin - Centre Hospitalier Universitaire de ToulousePierre Mondoly - Centre Hospitalier Universitaire de ToulouseLaurent Barandon - Hôpital Cardiologique du Haut-LévêqueMathieu Pernot - Hôpital Cardiologique du Haut-LévêqueMichel Kindo - Hôpitaux Universitaires de StrasbourgThomas Cardi - Hôpitaux Universitaires de StrasbourgPhilippe Gaudard - Université de MontpellierPhilippe Rouvière - Université de MontpellierThomas Sénage - Centre Hospitalier Universitaire de NantesNicolas Jacob - Centre Hospitalier Universitaire de NantesPascal Defaye - Centre Hospitalier Universitaire de GrenobleOlivier Chavanon - Hôpital Albert MichallonConstance Verdonk - Hôpital Bichat-Claude-BernardWalid Ghodbane - Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, FranceEdeline Pelcé - Hôpital de la TimoneVlad Gariboldi - Hôpital de la TimoneMatteo Pozzi - Hôpital Louis PradelJean-François Obadia - Department of Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, FranceArnaud Savouré - Centre Hospitalier Universitaire de RouenFrédéric Anselme - Centre Hospitalier Universitaire de RouenGerard Babatasi - Université de Caen NormandieAnnette Belin - Université de Caen NormandieFabien Garnier - Centre Hospitalier Universitaire Dijon BourgogneMarie Bielefeld - Department of Cardiology and Cardiac Surgery, University Hospital, Dijon, FranceDavid Hamon - Hôpitaux Universitaires Henri MondorNicolas Lellouche - Société Française de CardiologieBertrand Pierre - Université de ToursThierry Bourguignon - Université de ToursRomain Eschalier - Centre Hospitalier Universitaire de Clermont-FerrandNicolas D’Ostrevy - Centre Hospitalier Universitaire de Clermont-FerrandMarie-Cécile Bories - Hôpital Européen Georges-PompidouEloi Marijon - Société Française de CardiologieFabrice Vanhuyse - Charmo UniversityHugues Blangy - Charmo UniversityJean-Philippe Verhoye - Université de RennesChristophe Leclercq - Centre Hospitalier Universitaire de RennesRaphaël P. Martins - Laboratoire Traitement du Signal et de l'Image
- Resource Type
- Journal article
- Publication Details
- JACC. Clinical electrophysiology, Vol.5(8), pp.944-954
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jacep.2019.05.025
- PMID
- 31439296
- ISSN
- 2405-500X
- eISSN
- 2405-5018
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691512802771
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