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Ventricular arrhythmias following continuous‐flow left ventricular assist device implantation: A systematic review
Author(s) -
Gordon Jonathan S.,
Maynes Elizabeth J.,
Choi Jae Hwan,
Wood Chelsey T.,
Weber Matthew P.,
Morris Rohinton J.,
Massey H. Todd,
Tchantchaleishvili Vakhtang
Publication year - 2020
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.13665
Subject(s) - medicine , ventricular assist device , cardiology , ventricular tachycardia , heart transplantation , heart failure , ventricular fibrillation , continuous flow , surgery , physics , mechanics
Ventricular arrhythmias (VA) are not uncommon after continuous‐flow left ventricular assist device (CF‐LVAD) implantation. In this systematic review, we sought to identify the patterns of VA that occurred following CF‐LVAD implantation and evaluate their outcomes. An electronic search was performed to identify all articles reporting the development of VA following CF‐LVAD implantation. VA was defined as any episode of ventricular fibrillation (VF) or sustained (>30 seconds) ventricular tachycardia (VT). Eleven studies were pooled for the analysis that included 393 CF‐LVAD patients with VA. The mean patient age was 57 years [95%CI: 54; 61] and 82% [95%CI: 73; 88] were male. Overall, 37% [95%CI: 19; 60] of patients experienced a new onset VA after CF‐LVAD implantation, while 60% [95%CI: 51; 69] of patients had a prior history of VA. Overall, 88% of patients [95%CI: 78; 94] were supported on HeartMate II CF‐LVAD, 6% [95%CI: 3; 14] on HeartWare HVAD, and 6% [95%CI: 2; 13] on other CF‐LVADs. VA was symptomatic in 47% [95%CI: 28; 68] of patients and in 50% [95%CI: 37; 52], early VA (<30 days from CF‐LVAD) was observed. The 30‐day mortality rate was 7% [95%CI: 5; 11]. Mean follow‐up was 22.9 months [95%CI: 4.8; 40.8], during which 27% [95%CI: 17; 39] of patients underwent heart transplantation. In conclusion, approximately a third of patients had new VA following CF‐LVAD placement. VA in CF‐LVAD patients is often symptomatic, necessitates treatment, and carries a worse prognosis.