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Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications
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| Zeitschriftentitel: | Journal of the American Heart Association |
|---|---|
| Personen und Körperschaften: | , , , , , , , |
| In: | Journal of the American Heart Association, 8, 2019, 14 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. |
|---|---|
| author |
Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. |
| spellingShingle |
Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. Journal of the American Heart Association Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications Cardiology and Cardiovascular Medicine |
| author_sort |
alvarez, paulino a. |
| spelling |
Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.011813 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> The effect of implantable cardioverter defibrillators ( <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) in patients with continuous flow left ventricular assist devices ( <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s) on outcomes has not been evaluated in a randomized clinical trial. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> This is a retrospective single‐center study that included patients who underwent continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> implantation at the Cleveland Clinic between October 2004 and March 2017. Patients were evaluated according to the presence or absence of <jats:styled-content style="fixed-case">ICD</jats:styled-content> at the time of <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Among 486 patients in the study cohort, 387 (79.6%) had an <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> were older and had lower use of pre‐ <jats:styled-content style="fixed-case">LVAD</jats:styled-content> inotropes, extracorporeal membrane oxygenation, and mechanical ventilation. There were 81 patients (21.4% of patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) who required 93 procedures after <jats:styled-content style="fixed-case">LVAD</jats:styled-content> : 74 generator exchanges, 12 lead revisions, and 7 complete system removals because of infection. Of the 99 patients without <jats:styled-content style="fixed-case">ICD</jats:styled-content> , 52 (53%) underwent <jats:styled-content style="fixed-case">ICD</jats:styled-content> implantation: 29 for primary prevention and 23 for secondary prevention. Patients were followed for a median of 401 (interquartile range 150–966) days. The presence of a pre‐ <jats:styled-content style="fixed-case">LVAD ICD</jats:styled-content> was not associated with mortality in a multivariable model (hazard ratio 1.19, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.73–1.93, <jats:italic>P</jats:italic> =0.492), nor was the presence of an <jats:styled-content style="fixed-case">ICD</jats:styled-content> at any point when analyzed as a time‐varying covariate (hazard ratio 1.05, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.50–2.20, <jats:italic>P</jats:italic> =0.907). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> There is no apparent mortality benefit associated with an <jats:styled-content style="fixed-case">ICD</jats:styled-content> in a contemporary cohort of patients with continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s to balance considerable morbidity involving <jats:styled-content style="fixed-case">ICD</jats:styled-content> ‐related procedures and complications. </jats:p> </jats:sec> Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications Journal of the American Heart Association |
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Journal of the American Heart Association |
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| title |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_unstemmed |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_full |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_fullStr |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_full_unstemmed |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_short |
Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_sort |
implantable cardioverter defibrillators in patients with continuous flow left ventricular assist devices: utilization patterns, related procedures, and complications |
| topic |
Cardiology and Cardiovascular Medicine |
| url |
http://dx.doi.org/10.1161/jaha.118.011813 |
| publishDate |
2019 |
| physical |
|
| description |
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">
The effect of implantable cardioverter defibrillators (
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
) in patients with continuous flow left ventricular assist devices (
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
s) on outcomes has not been evaluated in a randomized clinical trial.
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">
This is a retrospective single‐center study that included patients who underwent continuous flow
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
implantation at the Cleveland Clinic between October 2004 and March 2017. Patients were evaluated according to the presence or absence of
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
at the time of
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
insertion. Among 486 patients in the study cohort, 387 (79.6%) had an
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
before
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
insertion. Patients with
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
before
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
were older and had lower use of pre‐
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
inotropes, extracorporeal membrane oxygenation, and mechanical ventilation. There were 81 patients (21.4% of patients with
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
) who required 93 procedures after
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
: 74 generator exchanges, 12 lead revisions, and 7 complete system removals because of infection. Of the 99 patients without
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
, 52 (53%) underwent
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
implantation: 29 for primary prevention and 23 for secondary prevention. Patients were followed for a median of 401 (interquartile range 150–966) days. The presence of a pre‐
<jats:styled-content style="fixed-case">LVAD ICD</jats:styled-content>
was not associated with mortality in a multivariable model (hazard ratio 1.19, 95%
<jats:styled-content style="fixed-case">CI</jats:styled-content>
0.73–1.93,
<jats:italic>P</jats:italic>
=0.492), nor was the presence of an
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
at any point when analyzed as a time‐varying covariate (hazard ratio 1.05, 95%
<jats:styled-content style="fixed-case">CI</jats:styled-content>
0.50–2.20,
<jats:italic>P</jats:italic>
=0.907).
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">
There is no apparent mortality benefit associated with an
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
in a contemporary cohort of patients with continuous flow
<jats:styled-content style="fixed-case">LVAD</jats:styled-content>
s to balance considerable morbidity involving
<jats:styled-content style="fixed-case">ICD</jats:styled-content>
‐related procedures and complications.
</jats:p>
</jats:sec> |
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| author | Alvarez, Paulino A., Sperry, Brett W., Pérez, Antonio L., Yaranov, Dmitry M., Randhawa, Varinder, Luthman, Jacob, Cantillon, Daniel J., Starling, Randall C. |
| author_facet | Alvarez, Paulino A., Sperry, Brett W., Pérez, Antonio L., Yaranov, Dmitry M., Randhawa, Varinder, Luthman, Jacob, Cantillon, Daniel J., Starling, Randall C., Alvarez, Paulino A., Sperry, Brett W., Pérez, Antonio L., Yaranov, Dmitry M., Randhawa, Varinder, Luthman, Jacob, Cantillon, Daniel J., Starling, Randall C. |
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| description | <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> The effect of implantable cardioverter defibrillators ( <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) in patients with continuous flow left ventricular assist devices ( <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s) on outcomes has not been evaluated in a randomized clinical trial. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> This is a retrospective single‐center study that included patients who underwent continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> implantation at the Cleveland Clinic between October 2004 and March 2017. Patients were evaluated according to the presence or absence of <jats:styled-content style="fixed-case">ICD</jats:styled-content> at the time of <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Among 486 patients in the study cohort, 387 (79.6%) had an <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> were older and had lower use of pre‐ <jats:styled-content style="fixed-case">LVAD</jats:styled-content> inotropes, extracorporeal membrane oxygenation, and mechanical ventilation. There were 81 patients (21.4% of patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) who required 93 procedures after <jats:styled-content style="fixed-case">LVAD</jats:styled-content> : 74 generator exchanges, 12 lead revisions, and 7 complete system removals because of infection. Of the 99 patients without <jats:styled-content style="fixed-case">ICD</jats:styled-content> , 52 (53%) underwent <jats:styled-content style="fixed-case">ICD</jats:styled-content> implantation: 29 for primary prevention and 23 for secondary prevention. Patients were followed for a median of 401 (interquartile range 150–966) days. The presence of a pre‐ <jats:styled-content style="fixed-case">LVAD ICD</jats:styled-content> was not associated with mortality in a multivariable model (hazard ratio 1.19, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.73–1.93, <jats:italic>P</jats:italic> =0.492), nor was the presence of an <jats:styled-content style="fixed-case">ICD</jats:styled-content> at any point when analyzed as a time‐varying covariate (hazard ratio 1.05, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.50–2.20, <jats:italic>P</jats:italic> =0.907). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> There is no apparent mortality benefit associated with an <jats:styled-content style="fixed-case">ICD</jats:styled-content> in a contemporary cohort of patients with continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s to balance considerable morbidity involving <jats:styled-content style="fixed-case">ICD</jats:styled-content> ‐related procedures and complications. </jats:p> </jats:sec> |
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| spelling | Alvarez, Paulino A. Sperry, Brett W. Pérez, Antonio L. Yaranov, Dmitry M. Randhawa, Varinder Luthman, Jacob Cantillon, Daniel J. Starling, Randall C. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.011813 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> The effect of implantable cardioverter defibrillators ( <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) in patients with continuous flow left ventricular assist devices ( <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s) on outcomes has not been evaluated in a randomized clinical trial. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> This is a retrospective single‐center study that included patients who underwent continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> implantation at the Cleveland Clinic between October 2004 and March 2017. Patients were evaluated according to the presence or absence of <jats:styled-content style="fixed-case">ICD</jats:styled-content> at the time of <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Among 486 patients in the study cohort, 387 (79.6%) had an <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> insertion. Patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> before <jats:styled-content style="fixed-case">LVAD</jats:styled-content> were older and had lower use of pre‐ <jats:styled-content style="fixed-case">LVAD</jats:styled-content> inotropes, extracorporeal membrane oxygenation, and mechanical ventilation. There were 81 patients (21.4% of patients with <jats:styled-content style="fixed-case">ICD</jats:styled-content> ) who required 93 procedures after <jats:styled-content style="fixed-case">LVAD</jats:styled-content> : 74 generator exchanges, 12 lead revisions, and 7 complete system removals because of infection. Of the 99 patients without <jats:styled-content style="fixed-case">ICD</jats:styled-content> , 52 (53%) underwent <jats:styled-content style="fixed-case">ICD</jats:styled-content> implantation: 29 for primary prevention and 23 for secondary prevention. Patients were followed for a median of 401 (interquartile range 150–966) days. The presence of a pre‐ <jats:styled-content style="fixed-case">LVAD ICD</jats:styled-content> was not associated with mortality in a multivariable model (hazard ratio 1.19, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.73–1.93, <jats:italic>P</jats:italic> =0.492), nor was the presence of an <jats:styled-content style="fixed-case">ICD</jats:styled-content> at any point when analyzed as a time‐varying covariate (hazard ratio 1.05, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.50–2.20, <jats:italic>P</jats:italic> =0.907). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> There is no apparent mortality benefit associated with an <jats:styled-content style="fixed-case">ICD</jats:styled-content> in a contemporary cohort of patients with continuous flow <jats:styled-content style="fixed-case">LVAD</jats:styled-content> s to balance considerable morbidity involving <jats:styled-content style="fixed-case">ICD</jats:styled-content> ‐related procedures and complications. </jats:p> </jats:sec> Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications Journal of the American Heart Association |
| spellingShingle | Alvarez, Paulino A., Sperry, Brett W., Pérez, Antonio L., Yaranov, Dmitry M., Randhawa, Varinder, Luthman, Jacob, Cantillon, Daniel J., Starling, Randall C., Journal of the American Heart Association, Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications, Cardiology and Cardiovascular Medicine |
| title | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_full | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_fullStr | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_full_unstemmed | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_short | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| title_sort | implantable cardioverter defibrillators in patients with continuous flow left ventricular assist devices: utilization patterns, related procedures, and complications |
| title_unstemmed | Implantable Cardioverter Defibrillators in Patients With Continuous Flow Left Ventricular Assist Devices: Utilization Patterns, Related Procedures, and Complications |
| topic | Cardiology and Cardiovascular Medicine |
| url | http://dx.doi.org/10.1161/jaha.118.011813 |