Clinical Electrophysiology -> Ventricular Arrhythmias -> Clinical Trials / Outcomes D-PO05 - Poster Session V (ID 39) Poster

D-PO05-230 - Impact Of Left Ventricular Remodeling On Arrhythmic Outcomes In Continuous Flow Left Ventricular Assist Device Recipients (ID 1320)

Abstract

Background: End stage heart failure patients treated with continuous flow left ventricular assist device (LVAD) have a high incidence of atrial (AA) and ventricular (VA) arrhythmias. The role of left ventricular (LV) remodeling on arrhythmic outcomes post-LVAD remains unclear.
Objective: The aim of the study was to evaluate improvement in LV dimensions and its association with post-LVAD AA, VA and implantable-cardioverter defibrillator (ICD) shocks.
Methods: A multi-center LVAD cardiac arrhythmia database was queried to identify patients who had LVAD implant between 2010 and 2015. The cohort was divided into 2 groups based on post-LVAD LV end-diastolic dimension (LVEDD) changes (improvement group and non-improvement group). Demographic and risk factors were evaluated between the groups. The primary outcome measures were post-LVAD AA, VA, and ICD shocks.
Results: A total of 419 patients were included in the final dataset of which 355 patients had some improvement in their post-LVAD LVEDD and 64 patients had no improvement. The median age, gender, pre-LVAD LV ejection fraction and use of ICDs were similar between the improvement and non-improvement groups (Table 1). The patients in improvement group were more likely to get post-LVAD AA (53% vs. 37%, p<0.01); however, the rates of VA and ICD shocks post-LVAD were comparable (Table 1).
Conclusion: The majority of LVAD recipients patients have improvement in their LV dimensions post-LVAD; however,this is not associated with reduced post-LVAD arrhythmias or ICD shocks.
Comparison of post-LVAD LVEDD improvement group to rest of patients
LVEDD Improvement Group (n= 355)LVEDD Non-Improvement Group (n= 64)p-value
Age61 (51-68)56 (47-64)0.06
Female gender20%18%0.7
Patients with ICD before LVAD implantation49%45%0.55
Pre-LVAD left ventricular ejection fraction15 (11-20)15 (12-20)0.39
Pre-LVAD left ventricular end-diastolic dimension7.1 (6.5-7.7)6.8 (6.1-7.5)0.03
Pre-LVAD left ventricular end-systolic dimension6.4 (5.7-7.2)6.1 (5.5-7.0)0.09
Post-LVAD atrial arrhythmias53%37%0.03
Post-LVAD ventricular arrhythmias55%43%0.11
Post-LVAD ICD shocks35%33%0.79
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