Abstract 14022: Implantable Cardioverter Defibrillator Does Not Impact Clinical Outcome in Left Ventricular Assist Device Patients
Background: The impact of implantable cardioverter defibrillator (ICD) on clinical outcome in patients with a continuous flow left ventricular assist device (LVAD) is not well understood.
Hypothesis: We hypothesized that ICD would improve survival in LVAD patients.
Methods: We evaluated the effect of an ICD on all-cause mortality in 172 patients with a HeartMate II LVAD implanted between May 2008 and November 2013 at the University of Rochester Medical Center, Rochester NY, enrolled in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Registry. The end point was all-cause mortality during the follow-up.
Results: There were 113 of 172 (66%) LVAD patients with an ICD implanted before the LVAD implantation procedure, with a mean age of 56.9 ± 12.2 years, 15 of them were female. During the median follow-up of 25 months, 31 of 113 patients (27%) with an ICD died compared to 17 of 59 patients (29%) without an ICD. There was no significant difference in the cumulative probability of all-cause mortality in patients with or without an implanted ICD (see Figure, p=0.949). Multivariate model after adjustment for age, gender, and history of CABG revealed no significant difference in death from any cause in patients implanted with an ICD vs. those without an ICD (HR=0.94, 95% CI: 0.52-1.71, p=0.845). This was consistent in patients with bridge-to-transplant or destination therapy LVADs, and across INTERMACS levels.
Conclusion: In patients with an implanted continuous flow left ventricular assist device, an ICD was not associated with improvement in all-cause mortality.
Author Disclosures: V. Kutyifa: Research Grant; Significant; Boston Scientific, Zoll. S. Sherazi: None. D.T. Huang: None. S. McNitt: None. A. Papernov: None. T. Massey: None. L. Chen: None. E. Storozynsky: None. W. Zareba: Research Grant; Significant; Boston Scientific. J. Alexis: None.
- © 2014 by American Heart Association, Inc.