1. Early Ventricular Arrhythmias After Left Ventricular Assist Device Implantation.
- Author
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Oates CP, Lam PH, Lawrence L, Bigham G, Meda NS, Basyal B, Hadadi CA, Rao SD, Hockstein M, Shah M, and Sheikh FH
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, Risk Factors, Postoperative Complications epidemiology, Postoperative Complications etiology, Incidence, Arrhythmias, Cardiac epidemiology, Arrhythmias, Cardiac therapy, Arrhythmias, Cardiac etiology, Time Factors, Tachycardia, Ventricular epidemiology, Tachycardia, Ventricular etiology, Tachycardia, Ventricular therapy, Follow-Up Studies, Heart-Assist Devices adverse effects, Heart Failure therapy, Heart Failure surgery, Heart Failure epidemiology
- Abstract
Background: Although sustained ventricular arrhythmias (VAs) are a common complication after durable left ventricular assist device (LVAD) implantation, the incidence, risk factors, and prognostic implications of postoperative early VAs (EVAs) in contemporary patients with LVAD are poorly understood., Methods and Results: A single-center retrospective analysis was performed of patients who underwent LVAD implantation from October 1, 2006, to October 1, 2022. EVA was defined as an episode of sustained VA identified ≤30 days after LVAD implantation. A total of 789 patients underwent LVAD implantation (mean age 62.9 ± 0. years 5, HeartMate 3 41.4%, destination therapy 43.3%). EVAs occurred in 100 patients (12.7%). A history of end-stage renal disease (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.45-21.70), preoperative electrical storm (OR 2.82, 95% CI 1.11-7.16), and appropriate implantable cardiac defibrillator therapy before implantation (OR 2.8, 95% CI 1.26-6.19) are independently associated with EVAs. EVA was associated with decreased 30-day survival (hazard ratio 3.02, 95% CI 1.1-8.3, P = .032). There was no difference in transplant-free survival time between patients with and without EVAs (hazard ratio 0.82, 95% CI 0.5-1.4, P = .454)., Conclusions: EVAs are common after durable LVAD implantation and are associated with an increased risk of 30-day mortality., Competing Interests: CONFLICT OF INTEREST Farooq H. Sheikh reports institutional research support and honorarium for speaking at educational conferences from Abbott. No company or agency had any role in this manuscript., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2024
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