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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2024
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/aor.14708 |
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Table of Contents:
- Real‐world data of patients affected by advanced heart failure treated with implantable cardioverter defibrillator and left ventricular assist device: Results of a multicenter observational study Roberto Rordorf Leonardo Pignalosa Matteo Casula Enrico Perna Matteo Baroni Andrea Garascia Stefania Guida Fabrizio Gazzoli Daniela Pini Francesco Cannata Marta Pellegrino Claudia Vittori Paolo De Filippo Giovanni Malanchini Pasquale Vergara Paolo Della Bella Simone Gulletta Artificial Organs AbstractBackgroundLeft ventricular assist device (L‐VAD) implantation is increasingly used in patients with heart failure (HF) and most patients also have an implantable cardioverter defibrillator (ICD). Limited data are available on the incidence of ICD therapies and complications in this special setting.The aim of this study was to analyze the real‐world incidence and predictors of ICD therapies, complications and interactions between ICD and L‐VAD.MethodsWe conducted a multicenter retrospective observational study in patients with advanced HF implanted with ICD and a continuous‐flow L‐VAD, followed‐up in five advanced HF centers in Northern Italy.ResultsA total of 234 patients (89.7% male, median age 59, 48.3% with ischemic etiology) were enrolled. After a median follow‐up of 21 months, 66 patients (28.2%) experienced an appropriate ICD therapy, 22 patients (9.4%) an inappropriate ICD therapy, and 17 patients (7.3%) suffered from an interaction between ICD and L‐VAD. The composite outcome of all ICD‐related complications was reported in 41 patients (17.5%), and 121 (51.7%) experienced an L‐VAD‐related complication. At multivariable analysis, an active ventricular tachycardia (VT) zone and a prior ICD generator replacement were independent predictors of ICD therapies and of total ICD‐related complications, respectively.ConclusionsReal‐world patients with both L‐VAD and ICD experience a high rate of ICD therapies and complications. Our findings suggest the importance of tailoring device programming in order to minimize the incidence of unnecessary ICD therapies, thus sparing the need for ICD generator replacement, a procedure associated to a high risk of complications. 10.1111/aor.14708 http://creativecommons.org/licenses/by-nc/4.0/