Clinical Electrophysiology -> Ventricular Arrhythmias -> Quality Measures & Complications D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-058 - Association Of Ventricular Arrhythmia Burden With Right Heart Failure And Death In Patients Supported By A Left Ventricular Assist Device (ID 1374)


Background: Right heart failure (RHF) is a highly morbid complication in continuous-flow (CF) left ventricular assist device (LVAD) patients. There are limited data on the association between ventricular tachycardia (VT) burden following CF-LVAD implantation and RHF or death.
Objective: We aimed to determine the association of VT burden with RHF and death in LVAD patients.
Methods: We studied 114 patients who underwent CF-LVAD implantation at a tertiary medical center from 10/2008 - 05/2019 and had an implantable cardioverter-defibrillator. All patients had complete data on arrhythmia burden captured through remote device monitoring. Burden of VT was defined as number of days with ≥1 episode of VT per patient-year of follow-up. RHF of any degree of severity was defined by INTERMACS criteria. Arrhythmia burden was compared in patients with and without RHF or death.
Results: Mean age at LVAD implantation was 56 ± 12 years and average duration of LVAD support was 3.7 ± 2.5 years. Sixty-two (54%) patients developed RHF and 21 (18%) patients died. Kaplan Meier survival analysis showed that the overall rate of a first occurrence of VT at 2 years of follow-up was 37% (Figure: left panel). The burden of VT was also greater in patients with RHF compared to patients without RHF (1.84 vs. 1.65 days/patient-year) and among those who developed the composite endpoint of RHF and death (1.81 vs. 1.68 days/patient-year) (Figure; right panel).
Conclusion: Increased burden of VT is associated with RHF and death in CF-LVAD patients. More aggressive management of ventricular tachyarrhythmias may be warranted in this population.