The Particulars: Left ventricular assist devices (LVADs) are increasingly being used to treat advanced heart failure, according to previous studies. The risks for ventricular arrhythmias and ICD shocks are high in this patient population. Studies have not yet determined if ICD shocks within 1 year prior to LVAD placement implantation predict postoperative ventricular arrhythmias, more ICD shocks, or mortality.
Data Breakdown: A retrospective analysis of 114 patients who underwent LVAD implantation between 2005 and 2013 found that 28 of these individuals received an ICD shock within 1 year prior to implantation. For these 28 patients, the odds of postoperative, in-hospital ICD shock, death, or both was 4.8 times higher than for those who did not have an ICD shock during the year prior to implantation. The in-hospital mortality rate was 16 times higher for patients who received a postoperative shock when compared with those who did not.
Take Home Pearls: An ICD shock during the year before an LVAD is placed appears to increase the risk of postoperative ICD shocks, mortality, or both. A post-LVAD placement shock appears to significantly raise the risk for in-hospital mortality in this patient population.
