Early Ventricular Arrhythmias after Left Ventricular Assist Device Implantation.

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Citation: Journal of Cardiac Failure. 2023 Dec 14PMID: 38103723Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Cardiovascular Disease Fellowship | Clinical Cardiac Electrophysiology Fellowship | Internal Medicine Residency | MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Surgery/Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023ISSN:
  • 1071-9164
Name of journal: Journal of cardiac failureAbstract: BACKGROUND: While sustained ventricular arrhythmias are a common complication following durable left ventricular assist device (LVAD) implantation, the incidence, risk factors, and prognostic implications of early postoperative ventricular arrhythmias (EVAs) in contemporary LVAD patients are poorly understood.CONCLUSION: EVAs are common after durable LVAD implantation and are associated with increased risk of 30-day mortality. Copyright © 2023. Published by Elsevier Inc.METHODS: A single-center retrospective analysis was performed of patients who underwent LVAD implantation from 10/1/2006-10/1/2022. EVA was defined as an episode of sustained ventricular arrhythmia identified <=30 days after LVAD implantation.RESULTS: A total of 789 patients underwent LVAD implantation (age: mean 62.9 years +/- 0.5, HeartMate 3: 41.4%, destination therapy: 43.3%). EVAs occurred in 100 (12.7%) patients. A history of ESRD (OR 5.6, CI 1.45-21.70), preoperative electrical storm (OR 2.82, CI 1.11-7.16) and appropriate ICD therapy prior to implantation (OR 2.8, CI 1.26-6.19) are independently associated with EVAs. EVA was associated with decreased 30-day survival (HR 3.02; 1.1-8.3 95% CI; p=0.032). There was no difference in transplant-free survival time between patients with and without EVAs (HR 0.82; 0.5-1.4 95% CI; p=0.454).All authors: Oates CP, Lam PH, Lawrence L, Bigham G, Meda NS, Basyal B, Hadadi CA, Rao SD, Hockstein M, Shah M, Sheikh FHFiscal year: FY2024Digital Object Identifier: Date added to catalog: 2024-01-22
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Journal Article MedStar Authors Catalog Article 38103723 Available 38103723

BACKGROUND: While sustained ventricular arrhythmias are a common complication following durable left ventricular assist device (LVAD) implantation, the incidence, risk factors, and prognostic implications of early postoperative ventricular arrhythmias (EVAs) in contemporary LVAD patients are poorly understood.

CONCLUSION: EVAs are common after durable LVAD implantation and are associated with increased risk of 30-day mortality. Copyright © 2023. Published by Elsevier Inc.

METHODS: A single-center retrospective analysis was performed of patients who underwent LVAD implantation from 10/1/2006-10/1/2022. EVA was defined as an episode of sustained ventricular arrhythmia identified <=30 days after LVAD implantation.

RESULTS: A total of 789 patients underwent LVAD implantation (age: mean 62.9 years +/- 0.5, HeartMate 3: 41.4%, destination therapy: 43.3%). EVAs occurred in 100 (12.7%) patients. A history of ESRD (OR 5.6, CI 1.45-21.70), preoperative electrical storm (OR 2.82, CI 1.11-7.16) and appropriate ICD therapy prior to implantation (OR 2.8, CI 1.26-6.19) are independently associated with EVAs. EVA was associated with decreased 30-day survival (HR 3.02; 1.1-8.3 95% CI; p=0.032). There was no difference in transplant-free survival time between patients with and without EVAs (HR 0.82; 0.5-1.4 95% CI; p=0.454).

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