Ventricular Arrhythmia With Continuous-Flow Left Ventricular Assist Devices
Early VAs were associated with a significant reduction in survival compared with late or no VAs.
HealthDay News — For patients post contemporary continuous flow left ventricular assist device (CF-LVAD) implantation, early ventricular arrhythmias (VAs) are associated with significantly reduced survival, according to a study published in JACC: Clinical Electrophysiology.
Brian D. Greet, MD, from the Baylor College of Medicine in Houston, and colleagues examined the incidence, predictors, and associated mortality of pre-implantation, early, and late VAs in 517 patients who underwent CF-LVAD implantation between 2000 and 2015. All VAs were analyzed; those occurring within 30 days of implant were defined as early.
The researchers observed a significant reduction in survival in association with early VAs (hazard ratio, 1.83) compared to late or no VAs. Prior cardiac surgery and pre-CF-LVAD ventricular tachycardia storm were included as pre-implant variables independently predictive of early VAs (odds ratios, 1.9 and 3.15, respectively). From 2000 to 2007, the incidence of early VAs was as high as 47%, while from 2008 to 2015, the highest incidence was below 22%.
"VAs within thirty days after CF-LVAD implantation are associated with an increased risk of death," the authors write. "Strategies to reduce arrhythmia burden shortly after CF-LVAD implantation warrant further investigation."
Greet BD, Pujara D, Burkland D, et al. Incidence, predictors, and significance of ventricular arrhythmias in patients with continuous-flow left ventricular assist devices [published November 2, 2017]. JACC Clin Electrophysiol. doi: 10.1016/j.jacep.2017.11.001