Journal article
Predictors and Clinical Impact of Late Ventricular Arrhythmias in Patients With Continuous-Flow Left Ventricular Assist Devices
JACC. Clinical electrophysiology, Vol.4(9), pp.1166-1175
09/2018
DOI: 10.1016/j.jacep.2018.05.006
PMID: 30236390
Abstract
This study aimed to evaluate the incidence, clinical impact, and predictors of late ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients aiming to clarify implantable cardioverter-defibrillator (ICD) indications.
The arrhythmic risk and need for ICD in patients implanted with an LVAD are not very well known.
This observational study was conducted in 19 centers between 2006 and 2016. Late VAs were defined as sustained ventricular tachycardia or fibrillation occurring >30 days post-LVAD implantation, without acute reversible cause and requiring appropriate ICD therapy, external electrical shock, or medical therapy.
Among 659 LVAD recipients, 494 (median 58.9 years of age; mean left ventricular ejection fraction 20.7 ± 7.4%; 73.1% HeartMate II, 18.6% HeartWare, 8.3% Jarvik 2000) were discharged alive from hospital and included in the final analysis. Late VAs occurred in 133 (26.9%) patients. Multivariable analysis identified 6 independent predictors of late VAs: VAs before LVAD implantation, atrial fibrillation before LVAD implantation, idiopathic etiology of the cardiomyopathy, heart failure duration >12 months, early VAs (<30 days post-LVAD), and no angiotensin-converting enzyme inhibitors during follow-up. The “VT-LVAD score” was created, identifying 4 risk groups: low (score 0 to 1), intermediate (score 2 to 4), high (score 5 to 6), and very high (score 7 to 10). The rates of VAs at 1 year were 0.0%, 8.0%, 31.0% and 55.0%, respectively.
Late VAs are common after LVAD implantation. The VT-LVAD score may help to identify patients at risk of late VAs and guide ICD indications in previously nonimplanted patients. (Determination of Risk Factors of Ventricular Arrhythmias [VAs] after implantation of continuous flow left ventricular assist device with continuous flow left ventricular assist device [CF-LVAD] [ASSIST-ICD]; NCT02873169)
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Details
- Title: Subtitle
- Predictors and Clinical Impact of Late Ventricular Arrhythmias in Patients With Continuous-Flow Left Ventricular Assist Devices
- Creators
- Vincent Galand - Université de RennesErwan Flécher - Université de RennesVincent Auffret - Laboratoire Traitement du Signal et de l'ImageStéphane Boulé - Centre Hospitalier Universitaire de LilleAndré Vincentelli - Centre Hospitalier Universitaire de LilleCamille Dambrin - Centre Hospitalier Universitaire de ToulousePierre Mondoly - Hôpital RangueilFrédéric Sacher - Hôpital Cardiologique du Haut-LévêqueKarine Nubret - Hôpital Cardiologique du Haut-LévêqueMichel Kindo - Hôpitaux Universitaires de StrasbourgThomas Cardi - Hôpitaux Universitaires de StrasbourgPhilippe Gaudard - Hôpital Arnaud de VilleneuvePhilippe Rouvière - Hôpital LapeyronieMagali Michel - Institut de Transplantation Urologie en NephrologieJean-Baptiste Gourraud - Centre Hospitalier Universitaire de NantesPascal Defaye - Hôpital Albert MichallonOlivier 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, FrancePierre-Yves Litzler - Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, FranceFrédéric Anselme - Hôpital Charles-NicolleGerard Babatasi - Université de Caen NormandieAnnette Belin - Université de Caen NormandieFabien Garnier - Centre Hospitalier Universitaire Dijon BourgogneMarie Bielefeld - Centre Hospitalier Universitaire Dijon BourgogneDavid Hamon - University of Iowa, Internal MedicineCostin Radu - Assistance Publique – Hôpitaux de ParisBertrand Pierre - Centre Hospitalier Universitaire de ToursThierry Bourguignon - Centre Hospitalier Universitaire de ToursRomain Eschalier - Centre Hospitalier Universitaire de Clermont-FerrandNicolas D’Ostrevy - Société Française de Médecine VasculaireMarie-Cécile Bories - Hôpital Européen Georges-PompidouEloi Marijon - Hôpital Européen Georges-PompidouFabrice Vanhuyse - Centre Hospitalier Universitaire de NancyHugues Blangy - Centre Hospitalier Universitaire de NancyJean-Philippe Verhoye - Université de RennesChristophe Leclercq - Université de RennesRaphaël P. Martins - Laboratoire Traitement du Signal et de l'ImageASSIST-ICD Investigators
- Resource Type
- Journal article
- Publication Details
- JACC. Clinical electrophysiology, Vol.4(9), pp.1166-1175
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jacep.2018.05.006
- PMID
- 30236390
- ISSN
- 2405-500X
- eISSN
- 2405-5018
- Number of pages
- 10
- Language
- English
- Date published
- 09/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984720701902771
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