Echocardiographic predictors of ventricular arrhythmias in patients with left ventricular assist devices and implantable cardioverter-defibrillator

• Verfasst von: Efimova, Elena [VerfasserIn]
• Verfasst von: Zeynalova, Samira [VerfasserIn]
• Verfasst von: Eifert, Sandra [VerfasserIn]
• Verfasst von: Dashkevich, Alexey [VerfasserIn]
• Verfasst von: Borger, Michael Andrew [VerfasserIn]
• Verfasst von: Meyer, Anna L. [VerfasserIn]
• Verfasst von: Garbade, Jens [VerfasserIn]
• Verfasst von: Darma, Angeliki [VerfasserIn]
• Verfasst von: Bode, Kerstin [VerfasserIn]
• Verfasst von: Arya, Arash [VerfasserIn]
• Titel: Echocardiographic predictors of ventricular arrhythmias in patients with left ventricular assist devices and implantable cardioverter-defibrillator
• Verf.angabe: Elena Efimova, Samira Zeynalova, Sandra Eifert, Alexey Dashkevich, Michael Andrew Borger, Anna L. Meyer, Jens Garbade, Angeliki Darma, Kerstin Bode, Arash Arya
• E-Jahr: 2025
• Jahr: February 2025
• Umfang: 9 S.
• Illustrationen: Diagramm
• Fussnoten: Zuerst veröffentlicht: 16. Dezember 2024
• Titel Quelle: Enthalten in: Journal of cardiovascular electrophysiology
• Ort Quelle: Oxford : Wiley-Blackwell, 1990
• Jahr Quelle: 2025
• Band/Heft Quelle: 36(2025), 2 vom: Feb., Seite 387-395
• ISSN Quelle: 1540-8167
• DOI: doi:10.1111/jce.16539
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: echocardiographic predictors
• Sach-SW: left ventricular assist device
• Sach-SW: ventricular arrhythmias
• K10plus-PPN: 1914528131

Abstract

Aim: To evaluate the predictive value of preoperative echocardiographic parameters for occurrence of VAs in patients with preexisting ICD undergoing LVAD implantation. Methods and Results: All consecutive patients (n = 264) with previous ICD who underwent LVAD surgery between May 2011 and December 2019 at our institution were included. The patients were predominantly male (89%) with NICM (59%) and a mean age of 59 ± 10 years. All LVADs were continuous flow device (154 HVAD, 21 HeartMate II, and 89 HeartMate 3). A total of 102 (39%) patients had VAs in the first year after LVAD implantation. We compared echocardiographic parameters in patients with and without VAs before LVAD, at 1 month and 1 year after LVAD implantation. Increased pre-LVEDD ≥ 72 mm predicted the occurrence of VAs after LVAD implantation for ICM patients (HR: 2.9, 95% confidence interval (CI): [1.3-6.6], p = 0.012), while a larger pre-RVEDD ≥ 46 mm was predictive in NICM patients (HR: 2.8, (CI): [1.4-5.9], p = 0.004). Moreover, a larger RVEDD at 1 year after LVAD was highly associated with VAs in the first year after LVAD implantation (50 ± 10 vs. 45 ± 8 mm, p = 0.001). All patients demonstrated a significant decrease in LVEDD as well as a reduction in severity of mitral and tricuspid regurgitation during 1 year after LVAD implantation, reflecting left ventricular unloading through the LVAD. Conclusions: Larger left and right ventricular diameters before LVAD predict the occurrence of VAs after LVAD implantation in ICM and NICM patients. Persistent RV remodeling post-LVAD is also associated with VAs.