Abstract | INTRODUCTION: METHODS: This was a retrospective study of all patients undergoing LVAD implantation from 1/2016 to 12/2019. Patients were divided into those with CRT and active LVP (CRT-LVP) immediately post-LVAD implant versus those without CRT-LVP. Implantable cardiac defibrillator electrograms were reviewed and early VAs were defined as sustained ventricular tachycardia (VT)/ ventricular fibrillation occurring within 30 days of LVAD implantation. RESULTS: Of 186 included patients (mean age 53 years, 75% male, mean body mass index 28), 72 had CRT devices, 63 of whom had LV pacing enabled after LVAD implant (CRT-LVP group). Patients with CRT-LVP were more likely to have VA in the early postoperative period (21% vs. 4%; p = .0001). All 9 patients with CRT in whom LVP was disabled had no early VA. Among those with early VA, patients with CRT-LVP were more likely to have monomorphic VT (77% vs. 40%; p = .07). In multiple logistic regression, CRT-LVP pacing remained an independent predictor of early VA after adjustment for history of VA and AF. CONCLUSIONS: Patients with CRT-LVP after LVAD implant had a higher incidence of early VA (specifically monomorphic VT). Epicardial LV pacing may be proarrhythmic in the early postoperative period after LVAD.
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Authors | Andrew Chou, John Larson, Amrish Deshmukh, Thomas M Cascino, Michael Ghannam, Rakesh Latchamsetty, Krit Jongnarangsin, Hakan Oral, Fred Morady, Frank Bogun, Keith D Aaronson, Francis D Pagani, Jackson J Liang |
Journal | Journal of cardiovascular electrophysiology
(J Cardiovasc Electrophysiol)
Vol. 33
Issue 5
Pg. 1024-1031
(05 2022)
ISSN: 1540-8167 [Electronic] United States |
PMID | 35245401
(Publication Type: Journal Article)
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Copyright | © 2022 Wiley Periodicals LLC. |
Topics |
- Arrhythmias, Cardiac
(diagnosis, epidemiology, therapy)
- Cardiac Resynchronization Therapy
(adverse effects)
- Female
- Heart Failure
(diagnosis, therapy)
- Heart-Assist Devices
(adverse effects)
- Humans
- Incidence
- Male
- Middle Aged
- Postoperative Period
- Retrospective Studies
- Tachycardia, Ventricular
(diagnosis, epidemiology, therapy)
- Treatment Outcome
- Ventricular Fibrillation
(diagnosis, epidemiology, therapy)
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