Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;58(3):243-252.
doi: 10.1007/s10840-019-00682-0. Epub 2019 Dec 14.

Ventricular arrhythmias in patients with biventricular assist devices

Andrew Y Lin  1 , Hao Tran  1 , Michela Brambatti  1 , Eric Adler  1 , Victor Pretorius  2 , Travis Pollema  2 , Jonathan C Hsu  1 , Gregory K Feld  1 , Kurt Hoffmayer  1 , Frederick Han  1 , David Krummen  1 , Gordon Ho  3
Affiliations

Ventricular arrhythmias in patients with biventricular assist devices

Andrew Y Lin et al. J Interv Card Electrophysiol. 2020 Sep.

Abstract

Purpose: Ventricular arrhythmias (VAs) are common in patients after left ventricular assist device (LVAD) implant and are associated with worse outcomes. However, the prevalence and impact of VA in patients with durable biventricular assist device (BIVAD) is unknown. We performed a retrospective cohort study of patients with BIVADs to evaluate the prevalence of VA and their clinical outcomes.

Methods: Consecutive patients who received a BIVAD between June 2014 and July 2017 at our medical center were included. The prevalence of VA, defined as sustained ventricular tachycardia or fibrillation requiring defibrillation or ICD therapy, was compared between BIVAD patients and a propensity-matched population of patients with LVAD from our center. The occurrence of adverse clinical events was compared between BIVAD patients with and without VA.

Results: Of the 13 patients with BIVADs, 6 patients (46%) experienced clinically significant VA, similar to a propensity-matched LVAD population (38%, p = 1.00). There were no differences in baseline characteristics between the two cohorts, except patients in the non-VA group who had worse hemodynamics (mitral regurgitation and right-sided indices), had less history of VA, and were younger. BIVAD patients with VA had a higher incidence of major bleeding (MR 3.05 (1.07-8.66), p = 0.036) and worse composite outcomes (log-rank test, p = 0.046). The presence of VA was associated with worse outcomes in both LVAD and BIVAD groups.

Conclusions: Ventricular arrhythmias are common in patients with BIVADs and are associated with worse outcomes. Future work should assess whether therapies such as ablation improve the outcome of BIVAD patients with VA.

Keywords: Biventricular assist device; Heart failure; Ventricular arrhythmia; Ventricular tachycardia.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Monthly incidence of ventricular arrhythmia per patient-year.
Figure 2.
Figure 2.
Kaplan Meier curve of composite outcome between groups, censored for transplant. A) Comparison of VA and non-VA patients with BIVADs. B) Comparison of VA and non-VA patients with LVADs. C) Comparison of VA group in BIVAD and VA group in LVAD patients.
See this image and copyright information in PMC

References

    1. Nair N, Gongora E. Reviewing the use of ventricular assist devices in the elderly: where do we stand today? Expert Rev Cardiovasc Ther. 2018;16:11–20. - PubMed
    1. Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65:2542–55. - PubMed
    1. Bedi M, Kormos R, Winowich S, McNamara DM, Mathier MA, Murali S. Ventricular arrhythmias during left ventricular assist device support. Am J Cardiol. 2007;99:1151–3. - PubMed
    1. Andersen M, Videbaek R, Boesgaard S, Sander K, Hansen PB, Gustafsson F. Incidence of ventricular arrhythmias in patients on long-term support with a continuous-flow assist device (HeartMate II). J Heart Lung Transplant. 2009;28:733–5. - PubMed
    1. Refaat M, Chemaly E, Lebeche D, Gwathmey JK, Hajjar RJ. Ventricular arrhythmias after left ventricular assist device implantation. Pacing Clin Electrophysiol. 2008;31:1246–52. - PMC - PubMed