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

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 FrigerioKlein Liviu, Kimberly N. Hong, Eric Adler, Oscar Braun

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.

Original languageEnglish
Pages (from-to)26-33
Number of pages8
JournalInternational Journal of Cardiology
Volume340
DOIs
Publication statusPublished - 1 Oct 2021

Bibliographical note

Funding Information:
This work was partially supported by the US National Institutes of Health (NIH), Grant UL1TR001442 of CTSA funding. The content is solely the responsibility of the authors and does not represent the official views of the NIH. OOB was supported by the Swedish Heart-Lung Foundation , the Crafoords Foundation, Märta Winklers Stiftelse and Thorsten Westerstroöms Stiftelse and ALF grants Region Skåne .

Funding Information:
JH reports receiving honoraria from Medtronic, Abbott, Boston Scientific, Biotronik, Janssen Pharmaceuticals, Bristol-Myers Squibb, Altathera Pharmaceuticals, Zoll Medical, and Biosense-Webster, equity in Acutus Medical and Vektor Medical, and research grants from Biotronik and Biosense-Webster. PS reports grant support from Abbott and consulting for Procyrion. LK reports consulting for Medtronic. MC reports institutional research grants from Novartis and Abbott, institutional clinical trial contracts from Novartis and Corvia, honoraria for lectures, presentations, educational events or Advisory Boards from Novartis, GE Healthcare, Pfizer, Bayer, Boehringer-Ingelheim, AstraZeneca, Teva Pharmaceutical Industries, Sanofi, LivaNova. EA reports receiving honoraria from Abbott and Medtronic.

Publisher Copyright:
© 2021 The Author(s)

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