Naslov
Cardiac implantable electronic devices with a defibrillator component and all-cause mortality in left ventricular assist device carriers: results from the PCHF-VAD registry

Autori
Čikeš, Maja ; Jakuš, Nina ; Claggett, B ; Brugts, JJ ; Timmermans, P ; Pouleur, AC ; Rubis, P ; Van Craenenbroeck, EM ; Gaizauskas, E ; Grundmann, S ; Paolillo, S ; Barge-Caballero, E ; D'Amario, D ; Gkouziouta, A ; Planinc, Ivo ; Veenis, JF ; Jacquet, LM ; Houard, L ; Holcman, K ; Gigase, A ; Rega, F ; Rucinskas, K ; Adamopoulos, S ; Agostoni, P ; Biočina, Bojan ; Gašparović, Hrvoje ; Lund, LH ; Flammer, AJ ; Metra, M ; Miličić, Davor ; Ruschitzka F

Izvornik
European journal of heart failure (1388-9842) 21 (2019), 9; 1129-1141

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
advanced heart failure ; cardiac implantable electronic device ; cardiac resynchronization therapy ; implantable cardioverter-defibrillators ; left ventricular assist devices ; mortality ; ventricular arrhythmia

Sažetak
Aims: To compare characteristics of left ventricular assist device (LVAD) recipients receiving a cardiac implantable electronic device (CIED) with a defibrillator component (implantable cardioverter-defibrillator and cardiac resynchronization therapy with defibrillation, CIED-D) vs. those without one, and to assess whether carrying such a device contiguously with an LVAD is associated with outcomes. Methods and results: Overall, 448 patients were analysed (mean age 52 ± 13 years, 82% male) in the multicentre European PCHF- VAD registry. To account for all active CIED-Ds during ongoing LVAD treatment, outcome analyses were performed by a time-varying analysis with active CIED-D status post-LVAD as the time-varying covariate. At the time of LVAD implantation, 235 patients (52%) had an active CIED-D. Median time on LVAD support was 1.1 years (interquartile range 0.5-2.0 years). A reduction of 36% in the risk of all-cause mortality was observed in patients with an active CIED-D [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.46-0.91 ; P = 0.012), increasing to 41% after adjustment for baseline covariates (HR 0.59, 95% CI 0.40- 0.87 ; P = 0.008) and 39% after propensity score adjustment (HR 0.61, 95% CI 0.39- 0.94 ; P = 0.027). Other than CIED-D, age, LVAD implant as redo surgery, number of ventricular arrhythmia episodes and use of vasopressors pre- LVAD were remaining significant risk factors of all-cause mortality. Incident ventricular arrhythmias post-LVAD portended a 2.4- fold and 2.6-fold increased risk of all-cause and cardiovascular death, respectively ; carrying an active CIED-D remained associated with a 47% and 43% reduction in these events, respectively. Conclusions: In an analysis accounting for all active CIED-Ds, including those implanted during LVAD support, carrying such a device was associated with significantly better survival during LVAD support.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA