Association of pre-left ventricular assist device defibrillator shocks for ventricular arrhythmia with clinical outcomes after left ventricular assist device implantation.

Autor:	Wann DG; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Baird AS; Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah., Wang NC; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Mulukutla SR; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Thoma FW; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Sezer A; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Canterbury AM; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Barakat AF; Cardiology Department, Ascension St. Vincent's Medical Center, Jacksonville, Florida., Gardner MW; Cardiology Department, Adventist Health, Portland, Oregon., Skowronski JN; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Aronis KN; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Voigt AH; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Jain SK; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Saba SF; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Bhonsale A; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Estes NAM; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Keebler ME; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Hickey GW; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Bazaz RR; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Kancharla K; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Heart rhythm O2 [Heart Rhythm O2] 2023 Oct 14; Vol. 4 (11), pp. 708-714. Date of Electronic Publication: 2023 Oct 14 (Print Publication: 2023).
DOI:	10.1016/j.hroo.2023.10.002
Abstrakt:	Background: Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks. Objectives: The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy. Methods: Patients 18 years or older with continuous-flow LVADs and ICDs were retrospectively identified within the University of Pittsburgh Medical Center system from 2006-2020. We analyzed the association between appropriate ICD shocks within 1 year pre-LVAD with a primary composite outcome of death, stroke, and pump thrombosis and secondary outcomes of post-LVAD ICD shocks and ICD shock hospitalizations. Results: Among 309 individuals, average age was 57 ± 12 years, 87% were male, 80% had ischemic cardiomyopathy, and 42% were bridge to transplantation. Seventy-one patients (23%) experienced pre-LVAD shocks, and 69 (22%) experienced post-LVAD shocks. The overall prevalence of shocks pre-LVAD and post-LVAD were not different. Pre-LVAD ICD shocks were not associated with the composite outcome. Pre-LVAD ICD shocks were found to predict post-LVAD shocks (hazard ratio [HR] 5.7; 95% confidence interval [CI] 3.42-9.48; P <.0001) and hospitalizations related to ICD shocks from ventricular arrhythmia (HR 10.34; 95% CI 4.1-25.7; P <.0001). Conclusion: Pre-LVAD ICD shocks predicted post-LVAD ICD shocks and hospitalizations but were not associated with the composite outcome of death, pump thrombosis, or stroke at 1 year. The prevalence of appropriate ICD shocks was similar before and after LVAD implantation in the entire cohort. (© 2023 Heart Rhythm Society. Published by Elsevier Inc.)
Databáze:	MEDLINE
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