Clinical experience of combined HeartWare ventricular assist device and implantable cardioverter defibrillator therapy
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Clinical experience of combined HeartWare ventricular assist device and implantable cardioverter defibrillator therapy. / Pecha, Simon; Wilke, Iris; Bernhardt, Alexander; Hakmi, Samer; Yildirim, Yalin; Steven, Daniel; Reichenspurner, Hermann; Willems, Stephan; Deuse, Tobias; Aydin, Ali.
in: J CARDIOVASC ELECTR, Jahrgang 25, Nr. 10, 10.2014, S. 1109-1114.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Clinical experience of combined HeartWare ventricular assist device and implantable cardioverter defibrillator therapy
AU - Pecha, Simon
AU - Wilke, Iris
AU - Bernhardt, Alexander
AU - Hakmi, Samer
AU - Yildirim, Yalin
AU - Steven, Daniel
AU - Reichenspurner, Hermann
AU - Willems, Stephan
AU - Deuse, Tobias
AU - Aydin, Ali
N1 - © 2014 Wiley Periodicals, Inc.
PY - 2014/10
Y1 - 2014/10
N2 - 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.
AB - 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.
KW - Combined Modality Therapy/instrumentation
KW - Defibrillators, Implantable
KW - Equipment Design
KW - Equipment Failure Analysis
KW - Female
KW - Heart Failure/diagnosis
KW - Heart-Assist Devices
KW - Humans
KW - Male
KW - Middle Aged
KW - Treatment Outcome
U2 - 10.1111/jce.12455
DO - 10.1111/jce.12455
M3 - SCORING: Journal article
C2 - 24862733
VL - 25
SP - 1109
EP - 1114
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 10
ER -