Circulation (New York, N.Y.), 2018-11-06, Vol.138 (Suppl_1 Suppl 1), p.A11758-A11758
IntroductionSustained ventricular arrhythmias (VA) are common in heart failure patients receiving continuous flow left ventricular assist devices (LVAD). Available studies evaluating the impact of VA on clinical outcomes in LVAD recipients have been single center and limited by small sample sizeHypothesisWe report the first multicenter study to assess the incidence, predictors, and outcomes associated with VA in LVAD patientsMethodsAnalysis was performed on 408 patients who underwent LVAD implantation at 5 centers from 2007-2015. VA was defined as sustained ventricular tachyarrhythmias lasting 〉30 sec or requiring ICD therapy. Effects of pre- and post-LVAD VA on survival was assessed using Kaplan-Meier analysis.ResultsOf 408 LVAD patients (Age 60 years), 254 (62%) had pre-LVAD VA (PreVA) and 154 (38%) did not (No-PreVA). At baseline, the PreVA group had greater male sex (85 vs 75%, p=0.02), amiodarone use (44 vs 31%, p=0.01), LV diastolic dimensions (7.1 vs 6.8 cm, p=0.01) and atrial arrhythmias (AA) (57 vs 45%, p=0.03). Compared to the No-PreVA group, the PreVA group had significantly higher incidence of post-LVAD VA (73 vs 37%, p〈 0.0001), AA (63 vs 42%, P〈0.0001), and ICD shocks (42 vs 32%, p=0.001) but similar rates of hospitalization (0.5 vs 0.5/100 days, p=0.7). During a median follow-up of 478 days, 35% of patients died in both groups. Kaplan-Meier analysis showed no difference in survival between the groups (Log Rank p=0.1Fig 1). Those who had both pre- and post-LVAD VA had similar survival as patients without any VA (Log rank p=0.1).ConclusionsIn this large, multicenter LVAD cohort, PreVA was associated with a significantly higher incidence of post-LVAD VA and ICD shocks. PreVA was not significantly associated with survival or all-cause hospitalizations.
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