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Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience
BACKGROUND: Limited data exist regarding complication rates of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy devices (CRT-D) in patients with left ventricular assist devices (LVAD). OBJECTIVE: We describe the incidence and characteristics of ICD- and CRT-D-relat...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710631/ https://www.ncbi.nlm.nih.gov/pubmed/34988518 http://dx.doi.org/10.1016/j.hroo.2021.09.005 |
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author | Ravichandran, Ashwin Pothineni, Naga Venkata K. Trivedi, Jaimin R. Roukoz, Henri Ahmed, Mustafa M. Bhan, Adarsh Bhat, Geetha Cowger, Jennifer Al Ahmad, Amin Natale, Andrea Di Biase, Luigi Slaughter, Mark S. Lakkireddy, Dhanunjaya Gopinathannair, Rakesh |
author_facet | Ravichandran, Ashwin Pothineni, Naga Venkata K. Trivedi, Jaimin R. Roukoz, Henri Ahmed, Mustafa M. Bhan, Adarsh Bhat, Geetha Cowger, Jennifer Al Ahmad, Amin Natale, Andrea Di Biase, Luigi Slaughter, Mark S. Lakkireddy, Dhanunjaya Gopinathannair, Rakesh |
author_sort | Ravichandran, Ashwin |
collection | PubMed |
description | BACKGROUND: Limited data exist regarding complication rates of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy devices (CRT-D) in patients with left ventricular assist devices (LVAD). OBJECTIVE: We describe the incidence and characteristics of ICD- and CRT-D-related procedures and complications in a multicenter LVAD cohort. METHODS: A total of 537 LVAD patients with a pre-existing ICD or CRT-D from 5 centers were included. Details on device type, device therapies, procedural complications, and long-term survival were analyzed. RESULTS: Of 537 patients, 280 had a CRT-D and 257 had ICD only. During a median follow-up of 538 days, 126 patients underwent generator replacement with significantly higher rate in the CRT group (79 [28.2%] vs 47 [18.3%], P = .0006). Device-related complications occurred in 36 (13%) CRT-D and 20 (8%) ICD patients (P = .06). Incidence of pocket hematoma (3.2% vs 2.7%), infection (4.3% vs 1.6%), and lead malfunction (3.1% vs 2.8%) was similar in both groups, with no effect of device complication on long-term survival (log-rank P = .7). There was a higher incidence of post-LVAD antitachycardia pacing for ventricular arrhythmias in the CRT-D group compared to the ICD group (35% vs 26%, P = .03). CONCLUSION: Cardiac implantable electronic device–related procedures are common in LVAD patients. Compared to ICD only, continued CRT-D therapy post-LVAD results in a significantly higher number of generator changes and a trend towards higher device- or lead-related complications. Device-related complications were not associated with reduced survival. |
format | Online Article Text |
id | pubmed-8710631 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-87106312022-01-04 Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience Ravichandran, Ashwin Pothineni, Naga Venkata K. Trivedi, Jaimin R. Roukoz, Henri Ahmed, Mustafa M. Bhan, Adarsh Bhat, Geetha Cowger, Jennifer Al Ahmad, Amin Natale, Andrea Di Biase, Luigi Slaughter, Mark S. Lakkireddy, Dhanunjaya Gopinathannair, Rakesh Heart Rhythm O2 Implantable Devices BACKGROUND: Limited data exist regarding complication rates of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy devices (CRT-D) in patients with left ventricular assist devices (LVAD). OBJECTIVE: We describe the incidence and characteristics of ICD- and CRT-D-related procedures and complications in a multicenter LVAD cohort. METHODS: A total of 537 LVAD patients with a pre-existing ICD or CRT-D from 5 centers were included. Details on device type, device therapies, procedural complications, and long-term survival were analyzed. RESULTS: Of 537 patients, 280 had a CRT-D and 257 had ICD only. During a median follow-up of 538 days, 126 patients underwent generator replacement with significantly higher rate in the CRT group (79 [28.2%] vs 47 [18.3%], P = .0006). Device-related complications occurred in 36 (13%) CRT-D and 20 (8%) ICD patients (P = .06). Incidence of pocket hematoma (3.2% vs 2.7%), infection (4.3% vs 1.6%), and lead malfunction (3.1% vs 2.8%) was similar in both groups, with no effect of device complication on long-term survival (log-rank P = .7). There was a higher incidence of post-LVAD antitachycardia pacing for ventricular arrhythmias in the CRT-D group compared to the ICD group (35% vs 26%, P = .03). CONCLUSION: Cardiac implantable electronic device–related procedures are common in LVAD patients. Compared to ICD only, continued CRT-D therapy post-LVAD results in a significantly higher number of generator changes and a trend towards higher device- or lead-related complications. Device-related complications were not associated with reduced survival. Elsevier 2021-12-17 /pmc/articles/PMC8710631/ /pubmed/34988518 http://dx.doi.org/10.1016/j.hroo.2021.09.005 Text en © 2021 Published by Elsevier Inc. on behalf of Heart Rhythm Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Implantable Devices Ravichandran, Ashwin Pothineni, Naga Venkata K. Trivedi, Jaimin R. Roukoz, Henri Ahmed, Mustafa M. Bhan, Adarsh Bhat, Geetha Cowger, Jennifer Al Ahmad, Amin Natale, Andrea Di Biase, Luigi Slaughter, Mark S. Lakkireddy, Dhanunjaya Gopinathannair, Rakesh Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title | Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title_full | Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title_fullStr | Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title_full_unstemmed | Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title_short | Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience |
title_sort | implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: a multicenter experience |
topic | Implantable Devices |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710631/ https://www.ncbi.nlm.nih.gov/pubmed/34988518 http://dx.doi.org/10.1016/j.hroo.2021.09.005 |
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