PMID- 37332585
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231103
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 10
DP  - 2023
TI  - Prognostic impact of implantable cardioverter defibrillators and associated 
      adverse events in patients with continuous flow left ventricular assist devices.
PG  - 1158248
LID - 10.3389/fcvm.2023.1158248 [doi]
LID - 1158248
AB  - OBJECTIVES: Implantation of implantable cardioverter defibrillators (ICD) reduces 
      the risk of all-cause mortality in symptomatic heart failure (HF) patients with 
      severe left ventricular (LV) dysfunction. Nevertheless, the prognostic impact of 
      ICD therapy in continuous flow left ventricular assist device (LVAD) recipients 
      remains controversial. METHODS: 162 consecutive HF patients, who underwent LVAD 
      implantation at our institution between 2010 and 2019, were categorized according 
      to the presence (n = 94, ICD-group) or absence (n = 68, Control-group) of ICDs. 
      Apart from clinical baseline and follow-up parameters, adverse events (AEs) 
      related to ICD therapy and overall survival rates were retrospectively analyzed. 
      RESULTS: Out of 162 consecutive LVAD recipients 79 patients (48.8%) were 
      preoperatively categorized as Interagency Registry for Mechanically Assisted 
      Circulatory Support (INTERMACS) profile </=2. The prevalence of severe HF symptoms 
      and preoperative use of short-term circulatory support devices (54.4% vs. 13.8%, 
      p < 0.001) was higher within the Control-group, although baseline severity of LV 
      and RV dysfunction was similar. Apart from an increased prevalence of 
      perioperative right heart failure (RHF) within the Control-group (45.6% vs. 
      17.0%; p < 0.001), procedural characteristics and perioperative outcome were 
      similar. Overall-survival during a median follow-up of 14 (3.0-36.5) months was 
      similar within both groups (p = 0.46). During the first 2 years after LVAD 
      implantation 53 ICD-related AEs occurred within the ICD-group. Thereof, 
      lead-dysfunction occurred in 19 patients and unplanned ICD-reintervention in 11 
      patients. Furthermore, in 18 patients appropriate shocks without loss of 
      consciousness occurred, whereas inappropriate shocks occurred in 5 patients. 
      CONCLUSION: ICD therapy in LVAD recipients was not associated with a survival 
      benefit or reduced morbidity after LVAD implantation. Conservative 
      ICD-programming seems to be justified to avoid ICD-related complications and 
      "awake shocks" after LVAD implantation.
CI  - (c) 2023 Pausch, Mersmann, Bhadra, Barten, Tonnis, Yildirim, Pecha, Reichenspurner 
      and Bernhardt.
FAU - Pausch, Jonas
AU  - Pausch J
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Mersmann, Julian
AU  - Mersmann J
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Bhadra, Oliver D
AU  - Bhadra OD
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Barten, Markus J
AU  - Barten MJ
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Tonnis, Tobias
AU  - Tonnis T
AD  - Department of Cardiology, University Heart & Vascular Center Hamburg, University 
      Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Yildirim, Yalin
AU  - Yildirim Y
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Pecha, Simon
AU  - Pecha S
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Reichenspurner, Hermann
AU  - Reichenspurner H
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Bernhardt, Alexander M
AU  - Bernhardt AM
AD  - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, 
      University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20230602
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC10272823
OTO - NOTNLM
OT  - Heart Failure
OT  - ICD
OT  - LVAD
OT  - Ventricular arrhythmias
OT  - implantable cardioverter defibrillator
OT  - left ventricular assist device
COIS- TT declared consulting activity for Medtronic and Boston Scientific, as well as 
      speaker honorarium from Medtronic. YY and SP declared consulting activity for 
      Medtronic and Philips Medical. HR declared travel grants and speaker honoraria 
      from Abbott and Abiomed. AB declared consulting activity for Abiomed, as well as 
      travel grants and speaker honoraria from Abbott and Abiomed.
EDAT- 2023/06/19 06:42
MHDA- 2023/06/19 06:43
PMCR- 2023/01/01
CRDT- 2023/06/19 02:38
PHST- 2023/02/03 00:00 [received]
PHST- 2023/05/15 00:00 [accepted]
PHST- 2023/06/19 06:43 [medline]
PHST- 2023/06/19 06:42 [pubmed]
PHST- 2023/06/19 02:38 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2023.1158248 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Jun 2;10:1158248. doi: 10.3389/fcvm.2023.1158248. 
      eCollection 2023.