Cardiovascular implantable electronic device therapy in patients with left ventricular assist devices: insights from TRAViATA

Douglas Darden, Enrico Ammirati, Michela Brambatti, Andrew Lin, Jonathan C. Hsu, Palak Shah, Enrico Perna, Maja Cikes, Grunde Gjesdal, Luciano Potena, Marco Masetti, Nina Jakus, Caroline Van De Heyning, Dina De Bock, Jasper J. Brugts, Claudio F. Russo, Jesse F. Veenis, Filip Rega, Manlio Cipriani, Maria FrigerioKlein Liviu, Kimberly N. Hong, Eric Adler, Oscar Braun

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is conflicting observational data on the survival benefit cardiac implantable electronic devices (CIED) in patients with LVADs. Methods: Patients in whom an LVAD was implanted between January 2008 and April 2017 in the multinational Trans-Atlantic Registry on VAD and Transplant (TRAViATA) registry were separated into four groups based on the presence of CIED prior to LVAD implantation: none (n = 146), implantable cardiac defibrillator (ICD) (n = 239), cardiac resynchronization without defibrillator (CRT-P) (n = 28), and CRT with defibrillator (CRT-D) (n = 111). Results: A total of 524 patients (age 52 years ±12, 84.4% male) were followed for 354 (interquartile range: 166–701) days. After multivariable adjustment, there were no differences in survival across the groups. In comparison to no device, only CRT-D was associated with late right ventricular failure (RVF) (hazard ratio 2.85, 95% confidence interval [CI] 1.42–5.72, p = 0.003). There was no difference in risk of early RVF across the groups or risk of ICD shocks between those with ICD and CRT-D. Conclusion: In a multinational registry of patients with LVADs, there were no differences in survival with respect to CIED subtype. However, patients with a pre-existing CRT-D had a higher likelihood of late RVF suggesting significant long-term morbidity in those with devices capable of LV‑lead pacing post LVAD implantation.

Original languageEnglish
Pages (from-to)26-33
JournalInternational Journal of Cardiology
Volume340
Issue number0
Early online date2021
DOIs
Publication statusPublished - 2021

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Free keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Implantable cardiac defibrillator
  • Left ventricular assist device
  • Mortality
  • Right ventricular failure

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