TY - JOUR
T1 - Effect of Continued Cardiac Resynchronization Therapy on Ventricular Arrhythmias After Left Ventricular Assist Device Implantation
AU - Schleifer, John William
AU - Mookadam, Farouk
AU - Kransdorf, Evan P.
AU - Nanda, Udai
AU - Adams, Jonathon C.
AU - Cha, Stephen
AU - Pajaro, Octavio E.
AU - Steidley, David Eric
AU - Scott, Robert L.
AU - Carvajal, Tomas
AU - Saadiq, Rayya A.
AU - Srivathsan, Komandoor
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/8/15
Y1 - 2016/8/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84977537433&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84977537433&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2016.05.050
DO - 10.1016/j.amjcard.2016.05.050
M3 - Article
C2 - 27328958
AN - SCOPUS:84977537433
SN - 0002-9149
VL - 118
SP - 556
EP - 559
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -