Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Cardiovascular implantable electronic device therapy in patients with left ventricular assist devices : insights from TRAViATA

Darden, Douglas ; Ammirati, Enrico ; Brambatti, Michela ; Lin, Andrew ; Hsu, Jonathan C. ; Shah, Palak ; Perna, Enrico ; Cikes, Maja ; Gjesdal, Grunde LU and Potena, Luciano , et al. (2021) In International Journal of Cardiology 340. p.26-33
Abstract

Background: There is conflicting observational data on the survival benefit cardiac implantable electronic devices (CIED) in patients with LVADs. Methods: Patients in whom an LVAD was implanted between January 2008 and April 2017 in the multinational Trans-Atlantic Registry on VAD and Transplant (TRAViATA) registry were separated into four groups based on the presence of CIED prior to LVAD implantation: none (n = 146), implantable cardiac defibrillator (ICD) (n = 239), cardiac resynchronization without defibrillator (CRT-P) (n = 28), and CRT with defibrillator (CRT-D) (n = 111). Results: A total of 524 patients (age 52 years ±12, 84.4% male) were followed for 354 (interquartile range: 166–701) days. After multivariable adjustment, there... (More)

Background: There is conflicting observational data on the survival benefit cardiac implantable electronic devices (CIED) in patients with LVADs. Methods: Patients in whom an LVAD was implanted between January 2008 and April 2017 in the multinational Trans-Atlantic Registry on VAD and Transplant (TRAViATA) registry were separated into four groups based on the presence of CIED prior to LVAD implantation: none (n = 146), implantable cardiac defibrillator (ICD) (n = 239), cardiac resynchronization without defibrillator (CRT-P) (n = 28), and CRT with defibrillator (CRT-D) (n = 111). Results: A total of 524 patients (age 52 years ±12, 84.4% male) were followed for 354 (interquartile range: 166–701) days. After multivariable adjustment, there were no differences in survival across the groups. In comparison to no device, only CRT-D was associated with late right ventricular failure (RVF) (hazard ratio 2.85, 95% confidence interval [CI] 1.42–5.72, p = 0.003). There was no difference in risk of early RVF across the groups or risk of ICD shocks between those with ICD and CRT-D. Conclusion: In a multinational registry of patients with LVADs, there were no differences in survival with respect to CIED subtype. However, patients with a pre-existing CRT-D had a higher likelihood of late RVF suggesting significant long-term morbidity in those with devices capable of LV‑lead pacing post LVAD implantation.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac resynchronization therapy, Heart failure, Implantable cardiac defibrillator, Left ventricular assist device, Mortality, Right ventricular failure
in
International Journal of Cardiology
volume
340
pages
26 - 33
publisher
Elsevier
external identifiers
  • pmid:34437934
  • scopus:85113945489
ISSN
0167-5273
DOI
10.1016/j.ijcard.2021.08.033
language
English
LU publication?
yes
id
695136f5-f3d4-4597-a275-65c2a9a4be8f
date added to LUP
2021-09-23 15:24:03
date last changed
2024-05-04 12:44:17
@article{695136f5-f3d4-4597-a275-65c2a9a4be8f,
  abstract     = {{<p>Background: There is conflicting observational data on the survival benefit cardiac implantable electronic devices (CIED) in patients with LVADs. Methods: Patients in whom an LVAD was implanted between January 2008 and April 2017 in the multinational Trans-Atlantic Registry on VAD and Transplant (TRAViATA) registry were separated into four groups based on the presence of CIED prior to LVAD implantation: none (n = 146), implantable cardiac defibrillator (ICD) (n = 239), cardiac resynchronization without defibrillator (CRT-P) (n = 28), and CRT with defibrillator (CRT-D) (n = 111). Results: A total of 524 patients (age 52 years ±12, 84.4% male) were followed for 354 (interquartile range: 166–701) days. After multivariable adjustment, there were no differences in survival across the groups. In comparison to no device, only CRT-D was associated with late right ventricular failure (RVF) (hazard ratio 2.85, 95% confidence interval [CI] 1.42–5.72, p = 0.003). There was no difference in risk of early RVF across the groups or risk of ICD shocks between those with ICD and CRT-D. Conclusion: In a multinational registry of patients with LVADs, there were no differences in survival with respect to CIED subtype. However, patients with a pre-existing CRT-D had a higher likelihood of late RVF suggesting significant long-term morbidity in those with devices capable of LV‑lead pacing post LVAD implantation.</p>}},
  author       = {{Darden, Douglas and Ammirati, Enrico and Brambatti, Michela and Lin, Andrew and Hsu, Jonathan C. and Shah, Palak and Perna, Enrico and Cikes, Maja and Gjesdal, Grunde and Potena, Luciano and Masetti, Marco and Jakus, Nina and Van De Heyning, Caroline and De Bock, Dina and Brugts, Jasper J. and Russo, Claudio F. and Veenis, Jesse F. and Rega, Filip and Cipriani, Manlio and Frigerio, Maria and Liviu, Klein and Hong, Kimberly N. and Adler, Eric and Braun, Oscar}},
  issn         = {{0167-5273}},
  keywords     = {{Cardiac resynchronization therapy; Heart failure; Implantable cardiac defibrillator; Left ventricular assist device; Mortality; Right ventricular failure}},
  language     = {{eng}},
  pages        = {{26--33}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{Cardiovascular implantable electronic device therapy in patients with left ventricular assist devices : insights from TRAViATA}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2021.08.033}},
  doi          = {{10.1016/j.ijcard.2021.08.033}},
  volume       = {{340}},
  year         = {{2021}},
}