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Echocardiographic predictors of ventricular arrhythmias in patients with left ventricular assist devices and implantable cardioverter-defibrillator

Aim: To evaluate the predictive value of preoperative echocardiographic parameters for occurrence of VAs in patients with preexisting ICD undergoing LVAD implantation. Methods and Results: All consecutive patients (n = 264) with previous ICD who underwent LVAD surgery between May 2011 and December 2...

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Main Authors: Efimova, Elena (Author) , Zeynalova, Samira (Author) , Eifert, Sandra (Author) , Dashkevich, Alexey (Author) , Borger, Michael Andrew (Author) , Meyer, Anna L. (Author) , Garbade, Jens (Author) , Darma, Angeliki (Author) , Bode, Kerstin (Author) , Arya, Arash (Author)
Format: Article (Journal)
Language:English
Published: February 2025
In: Journal of cardiovascular electrophysiology
Year: 2025, Volume: 36, Issue: 2, Pages: 387-395
ISSN:1540-8167
DOI:10.1111/jce.16539
Online Access:Resolving-System, kostenfrei: https://doi.org/10.1111/jce.16539
Resolving-System, kostenfrei: https://doi.org/10.25673/119312
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Author Notes:Elena Efimova, Samira Zeynalova, Sandra Eifert, Alexey Dashkevich, Michael Andrew Borger, Anna L. Meyer, Jens Garbade, Angeliki Darma, Kerstin Bode, Arash Arya
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Summary:Aim: To evaluate the predictive value of preoperative echocardiographic parameters for occurrence of VAs in patients with preexisting ICD undergoing LVAD implantation. Methods and Results: All consecutive patients (n = 264) with previous ICD who underwent LVAD surgery between May 2011 and December 2019 at our institution were included. The patients were predominantly male (89%) with NICM (59%) and a mean age of 59 ± 10 years. All LVADs were continuous flow device (154 HVAD, 21 HeartMate II, and 89 HeartMate 3). A total of 102 (39%) patients had VAs in the first year after LVAD implantation. We compared echocardiographic parameters in patients with and without VAs before LVAD, at 1 month and 1 year after LVAD implantation. Increased pre-LVEDD ≥ 72 mm predicted the occurrence of VAs after LVAD implantation for ICM patients (HR: 2.9, 95% confidence interval (CI): [1.3-6.6], p = 0.012), while a larger pre-RVEDD ≥ 46 mm was predictive in NICM patients (HR: 2.8, (CI): [1.4-5.9], p = 0.004). Moreover, a larger RVEDD at 1 year after LVAD was highly associated with VAs in the first year after LVAD implantation (50 ± 10 vs. 45 ± 8 mm, p = 0.001). All patients demonstrated a significant decrease in LVEDD as well as a reduction in severity of mitral and tricuspid regurgitation during 1 year after LVAD implantation, reflecting left ventricular unloading through the LVAD. Conclusions: Larger left and right ventricular diameters before LVAD predict the occurrence of VAs after LVAD implantation in ICM and NICM patients. Persistent RV remodeling post-LVAD is also associated with VAs.
Item Description:Zuerst veröffentlicht: 16. Dezember 2024
Physical Description:Online Resource
ISSN:1540-8167
DOI:10.1111/jce.16539

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