Back to Search
Start Over
Left ventricular assist device in the presence of subcutaneous implantable cardioverter defibrillator: Data from a multicenter experience.
- Source :
-
International journal of cardiology [Int J Cardiol] 2024 Apr 01; Vol. 400, pp. 131807. Date of Electronic Publication: 2024 Jan 23. - Publication Year :
- 2024
-
Abstract
- Background: Left ventricular assist devices (LVADs) are an increasingly used strategy for the management of patients with advanced heart failure (HF). Subcutaneous implantable cardioverter defibrillator (S-ICD) might be a viable alternative to conventional ICDs with a lower risk of short- and long-term of device-related complications and infections.The aim of this multicenter study was to evaluate the outcomes and management of S-ICD recipients who underwent LVAD implantation.<br />Methods: The study population included patients with a preexisting S-ICD who underwent LVAD implantation for advanced HF despite optimal medical therapy.<br />Results: The study population included 30 patients (25 male; median age 45 [38-52] years).The HeartMate III was the most common LVAD type. Median follow-up in the setting of concomitant use of S-ICDs and LVADs was 7 months (1-20).There were no reports of inability to interrogate S-ICD systems in this population. Electromagnetic interference (EMI) occurred in 21 (70%) patients. The primary sensing vector was the one most significantly involved in determining EMI. Twenty-seven patients (90%) remained eligible for S-ICD implantation with at least one optimal sensing vector. The remaining 3 patients (10%) were ineligible for S-ICD after attempts of reprogramming of sensing vectors. Six patients (20%) experienced inappropriate shocks (IS) due to EMI. Six patients (20%) experienced appropriate shocks. No S-ICD extraction because of need for antitachycardia pacing, ineffective therapy or infection was reported.<br />Conclusions: Concomitant use of LVAD and S-ICD is feasible in most patients. However, the potential risk of EMI oversensing, IS and undersensing in the post-operative period following LVAD implantation should be considered. Careful screening for EMI should be performed in all sensing vectors after LVAD implantation.<br />Competing Interests: Declaration of competing interest This was an independent study. No external funding was received for this project. CT is a member of Boston Scientific advisory board; FM scientific consultant for Boston Scientific and Cook Medical. RT is a consultant for BostonScientific and received speaker's honoraria from Boston Scientific. Other authors do no report disclosures regarding this article.<br /> (Copyright © 2024 Elsevier B.V. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 400
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38272130
- Full Text :
- https://doi.org/10.1016/j.ijcard.2024.131807