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Oscar Braun

Physician

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

Author

  • Douglas Darden
  • Enrico Ammirati
  • Michela Brambatti
  • Andrew Lin
  • Jonathan C. Hsu
  • Palak Shah
  • Enrico Perna
  • Maja Cikes
  • Grunde Gjesdal
  • Luciano Potena
  • Marco Masetti
  • Nina Jakus
  • Caroline Van De Heyning
  • Dina De Bock
  • Jasper J. Brugts
  • Claudio F. Russo
  • Jesse F. Veenis
  • Filip Rega
  • Manlio Cipriani
  • Maria Frigerio
  • Klein Liviu
  • Kimberly N. Hong
  • Eric Adler
  • Oscar Braun

Summary, in English

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.

Department/s

  • Cardiology
  • Heart Failure and Mechanical Support

Publishing year

2021

Language

English

Pages

26-33

Publication/Series

International Journal of Cardiology

Volume

340

Document type

Journal article

Publisher

Elsevier

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Implantable cardiac defibrillator
  • Left ventricular assist device
  • Mortality
  • Right ventricular failure

Status

Published

Research group

  • Heart Failure and Mechanical Support

ISBN/ISSN/Other

  • ISSN: 0167-5273