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Clinical Experience of Combined HeartWare Ventricular Assist Device and Implantable Cardioverter Defibrillator Therapy
Author(s) -
PECHA SIMON,
WILKE IRIS,
BERNHARDT ALEXANDER,
HAKMI SAMER,
YILDIRIM YALIN,
STEVEN DANIEL,
REICHENSPURNER HERMANN,
WILLEMS STEPHAN,
DEUSE TOBIAS,
AYDIN ALI
Publication year - 2014
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12455
Subject(s) - medicine , implantable cardioverter defibrillator , cardiology , ventricular assist device , atrial fibrillation , ventricular fibrillation , incidence (geometry) , heart failure , physics , optics
HeartWare Ventricular Assist Device and Implantable Cardioverter Defibrillator Introduction The HeartWare continuous flow ventricular assist device (HVAD) is used in an increasing number of heart failure patients. In those patients, ventricular arrhythmias (VAs) are common and, consequently, many patients already have an implanted implantable cardioverter defibrillator (ICD) in place or receive ICD implantation after left ventricular assist device implantation. However, limited data on feasibility and necessity of combined ICD and HVAD therapy are available. In this study we present our technical and clinical experience. Methods and Results Between 01/2010 and 06/2013, 41 patients received HVAD implantation. Twenty‐six HVAD patients who already had an ICD device placed prior to HVAD implantation or received ICD implantation afterwards were enrolled in this study. Peri‐ and postoperative complications as well as ICD interrogations were documented and analyzed retrospectively. Mean patients age was 58.4 ± 12.6 years; 88.5% of patients were male. During mean follow‐up of 12.2 ± 8.9 months, appropriate ICD interventions occurred in 9 patients (34.6%) due to ventricular tachyarrhythmia (n = 7) or ventricular fibrillation (n = 2). An inappropriate ICD intervention was seen in 1 patient (3.9%) due to tachycardic atrial fibrillation. Patients on HVAD with a history of VAs (n = 13) had a significantly higher incidence of ICD interventions compared to patients with primary prophylactic indication for ICD (n = 13; 53.8% vs. 7.7%; P = 0.015). No disturbance of ICD function was seen after HVAD implantation. Conclusion Combined ICD and HVAD therapy was safe and feasible, without electromagnetic interference between ICD and ventricular assist device. The incidence of ICD interventions was high in patients with a history of VAs, but low in patients with ICD implantation for primary prevention.