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Ventricular arrhythmias in patients with biventricular assist devices. | LitMetric

Ventricular arrhythmias in patients with biventricular assist devices.

J Interv Card Electrophysiol

Division of Cardiology, Department of Medicine, Cardiovascular Institute, University of California San Diego, 9452 Medical Center Dr. MC 7411, La Jolla, CA, 92037, USA.

Published: September 2020

AI Article Synopsis

  • Ventricular arrhythmias (VAs) are frequent in patients with biventricular assist devices (BIVADs) and linked to poorer health outcomes, similar to those observed in patients with left ventricular assist devices (LVADs).
  • A study reviewed data from patients with BIVADs from June 2014 to July 2017, finding that 46% experienced significant VAs, comparable to the 38% of matched LVAD patients.
  • BIVAD patients with VAs had higher rates of major bleeding and worse overall clinical outcomes, indicating that the presence of VAs negatively impacts patient health in both BIVAD and LVAD populations.

Article Abstract

Purpose: Ventricular arrhythmias (VAs) are common in patients after left ventricular assist device (LVAD) implant and are associated with worse outcomes. However, the prevalence and impact of VA in patients with durable biventricular assist device (BIVAD) is unknown. We performed a retrospective cohort study of patients with BIVADs to evaluate the prevalence of VA and their clinical outcomes.

Methods: Consecutive patients who received a BIVAD between June 2014 and July 2017 at our medical center were included. The prevalence of VA, defined as sustained ventricular tachycardia or fibrillation requiring defibrillation or ICD therapy, was compared between BIVAD patients and a propensity-matched population of patients with LVAD from our center. The occurrence of adverse clinical events was compared between BIVAD patients with and without VA.

Results: Of the 13 patients with BIVADs, 6 patients (46%) experienced clinically significant VA, similar to a propensity-matched LVAD population (38%, p = 1.00). There were no differences in baseline characteristics between the two cohorts, except patients in the non-VA group who had worse hemodynamics (mitral regurgitation and right-sided indices), had less history of VA, and were younger. BIVAD patients with VA had a higher incidence of major bleeding (MR 3.05 (1.07-8.66), p = 0.036) and worse composite outcomes (log-rank test, p = 0.046). The presence of VA was associated with worse outcomes in both LVAD and BIVAD groups.

Conclusions: Ventricular arrhythmias are common in patients with BIVADs and are associated with worse outcomes. Future work should assess whether therapies such as ablation improve the outcome of BIVAD patients with VA.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293581PMC
http://dx.doi.org/10.1007/s10840-019-00682-0DOI Listing

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