Prospective Randomized Evaluation of Implantable Cardioverter-Defibrillator Programming in Patients With a Left Ventricular Assist Device

Journal of the American Heart Association
Travis D RichardsonChristopher R Ellis

Abstract

Ventricular arrhythmias are common in patients with left ventricular assist devices (LVADs) but are often hemodynamically tolerated. Optimal implantable cardioverter defibrillator (ICD) tachy-programming strategies in patients with LVAD have not been determined. We sought to determine if an ultra-conservative ICD programming strategy in patients with LVAD affects ICD shocks. Adult patients with an existing ICD undergoing continuous flow LVAD implantation were randomized to standard ICD programming by their treating physician or an ultra-conservative ICD programming strategy utilizing maximal allowable intervals to detection in the ventricular fibrillation and ventricular tachycardia zones with use of ATP. Patients with cardiac resynchronization therapy (CRT) devices were also randomized to CRT ON or OFF. Patients were followed a minimum of 6 months. The primary outcome was time to first ICD shock. Among the 83 patients studied, we found no statistically significant difference in time to first ICD shock or total ICD shocks between groups. In the ultra-conservative group 16% of patients experienced at least one shock compared with 21% in the control group (P=0.66). There was no difference in mortality, arrhythmic hospitalization,...Continue Reading

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Citations

Jul 14, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Nirav PatelAbhishek Jaiswal
Sep 12, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Aswini KumarJeffrey Kluger
Nov 27, 2019·Current Heart Failure Reports·Jacinthe BouletAnique Ducharme
Feb 12, 2020·Artificial Organs·Jonathan S GordonVakhtang Tchantchaleishvili
Mar 19, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Andreas GoetteUNKNOWN ESC Scientific Document Group
Apr 11, 2020·Journal of Cardiovascular Electrophysiology·Eric Black-MaierJonathan P Piccini
Dec 12, 2018·The Cochrane Database of Systematic Reviews·Mohamad El MohebMarwan Refaat
Mar 25, 2020·Current Opinion in Cardiology·Joan A MaradeyPrashant D Bhave
Jan 4, 2022·Pacing and Clinical Electrophysiology : PACE·Alexander RobinsonSeth H Sheldon

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