Effect of Continued Cardiac Resynchronization Therapy on Ventricular Arrhythmias after Left Ventricular Assist Device Implantation

• Published in: The American journal of cardiology 2016-08, Vol.118 (4), p.556-559
• Main Authors: Schleifer, J. William, MD, Mookadam, Farouk, MBBCh, Kransdorf, Evan P., MD, PhD, Nanda, Udai, DO, Adams, Jonathon C., MD, Cha, Stephen, MSc, Pajaro, Octavio E., MD, PhD, Steidley, D. Eric, MD, Scott, Robert L., MD, PhD, Carvajal, Tomas, MD, Saadiq, Rayya A., DO, Srivathsan, Komandoor, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cardiac arrhythmia; Cardiac Resynchronization Therapy - methods; Cardiac Resynchronization Therapy Devices; Cardiomyopathy; Cardiovascular; Defibrillators; Defibrillators, Implantable; Electric Countershock; Female; Heart failure; Heart Failure - therapy; Heart-Assist Devices; Humans; Male; Middle Aged; Mortality; Patients; Tachycardia, Ventricular - epidemiology; Tachycardia, Ventricular - therapy; Transplants & implants; Ventricular Fibrillation - epidemiology; Ventricular Fibrillation - therapy
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.05.050

Abstract Cardiac resynchronization therapy (CRT) reduces ventricular arrhythmia (VA) burden in some heart failure patients, but its effect following left ventricular assist device (LVAD) implantation is unknown. We compared VA burden in patients with CRT devices in situ who underwent LVAD implantation and continued CRT (n = 39) to those who had CRT turned off prior to discharge (n = 26). ICD shocks were significantly reduced in patients with continued CRT (1.5 ± 2.7 shocks per patient versus 5.5 ± 9.3 with CRT off, p = 0.014). There was a nonsignificant reduction in cumulative VA episodes per patient with CRT continued at discharge (42 ± 105 VA per patient versus 82 ± 198 with CRT off, p = 0.29). On-treatment analysis by whether CRT was on or off identified a significantly lower burden of VA (17 ± 1 per patient-year CRT on versus 37 ± 1 per patient year CRT off, p