Prospective Evaluation of Implantable Cardioverter-Defibrillator Lead Function During and After Left Ventricular Assist Device Implantation.

JACC. Clinical Electrophysiology
Yuhning L HuJordana Kron

Abstract

This study investigated the mechanism of lead malfunction by monitoring lead parameters throughout left ventricular assist device (LVAD) implantation. Implantable cardioverter-defibrillator (ICD) lead malfunction can occur after LVAD implantation. ICD lead data were prospectively evaluated during and after LVAD implantation and at 12 pre-specified intraoperative time points. We prospectively evaluated 32 patients with ICDs who underwent LVAD implantation, of whom 20 patients underwent serial testing at 12 intraoperative steps. Post-operative right ventricle (RV) sensing had decreased by >50% from baseline in 7 patients (22%), with RV sensing improving at 1 to 7 weeks in 2 patients (28.6%). Nine patients (28.1%) had >10-ohm (Ω) high-voltage (HV) impedance changes from baseline to final impedance. In all 5 patients with >50% decrease in RV sensing and all 7 patients with a >10-Ω HV impedance change who underwent intraoperative testing, changes were not detected until after weaning from cardiopulmonary bypass. Patients with decreased RV lead sensing >50% (n = 7) had lower glomerular filtration rates (48.7 ± 21.9 ml/min/1.73 m2 vs. 68.4 ± 22.5 ml/min/1.73 m2, respectively, p = 0.0489), were more likely to have undergone concomitant...Continue Reading

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Citations

Jan 28, 2020·Circulation. Arrhythmia and Electrophysiology·Charles D SwerdlowKenneth A Ellenbogen
Apr 11, 2020·Journal of Cardiovascular Electrophysiology·Eric Black-MaierJonathan P Piccini
Jul 7, 2020·Pacing and Clinical Electrophysiology : PACE·Vincent GalandRaphaël P Martins
May 13, 2021·Pacing and Clinical Electrophysiology : PACE·Banveet Kaur KhetarpalKomandoor Srivathsan

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