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

John William Schleifer, Farouk Mookadam, Evan P. Kransdorf, Udai Nanda, Jonathon C. Adams, Stephen Cha, Octavio E. Pajaro, D Eric Steidley, Robert L Scott, Tomas Carvajal, Rayya A. Saadiq, Komandoor Srivathsan

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Abstract

Cardiac resynchronization therapy (CRT) reduces ventricular arrhythmia (VA) burden in some patients with heart failure, but its effect after 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 before discharge (n = 26). Implantable cardioverter-defibrillator (ICD) shocks were significantly reduced in patients with continued CRT (1.5 ± 2.7 shocks per patient vs 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 vs 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 vs 37 ± 1 per patient-year CRT off, p <0.0001) and ICD shocks (1.2 ± 0.3 per patient-year CRT on vs 1.7 ± 0.3 per patient-year CRT off, p = 0.018). In conclusion, continued CRT is associated with significantly reduced ICD shocks and VA burden after LVAD implantation.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StateAccepted/In press - Mar 1 2016

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Cardiac Resynchronization Therapy
Heart-Assist Devices
Cardiac Arrhythmias
Implantable Defibrillators
Shock
Cardiac Resynchronization Therapy Devices

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of Continued Cardiac Resynchronization Therapy on Ventricular Arrhythmias After Left Ventricular Assist Device Implantation. / Schleifer, John William; Mookadam, Farouk; Kransdorf, Evan P.; Nanda, Udai; Adams, Jonathon C.; Cha, Stephen; Pajaro, Octavio E.; Steidley, D Eric; Scott, Robert L; Carvajal, Tomas; Saadiq, Rayya A.; Srivathsan, Komandoor.

In: American Journal of Cardiology, 01.03.2016.

Research output: Contribution to journalArticle

Schleifer, John William ; Mookadam, Farouk ; Kransdorf, Evan P. ; Nanda, Udai ; Adams, Jonathon C. ; Cha, Stephen ; Pajaro, Octavio E. ; Steidley, D Eric ; Scott, Robert L ; Carvajal, Tomas ; Saadiq, Rayya A. ; Srivathsan, Komandoor. / Effect of Continued Cardiac Resynchronization Therapy on Ventricular Arrhythmias After Left Ventricular Assist Device Implantation. In: American Journal of Cardiology. 2016.
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abstract = "Cardiac resynchronization therapy (CRT) reduces ventricular arrhythmia (VA) burden in some patients with heart failure, but its effect after 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 before discharge (n = 26). Implantable cardioverter-defibrillator (ICD) shocks were significantly reduced in patients with continued CRT (1.5 ± 2.7 shocks per patient vs 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 vs 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 vs 37 ± 1 per patient-year CRT off, p <0.0001) and ICD shocks (1.2 ± 0.3 per patient-year CRT on vs 1.7 ± 0.3 per patient-year CRT off, p = 0.018). In conclusion, continued CRT is associated with significantly reduced ICD shocks and VA burden after LVAD implantation.",
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