Use of implantable cardioverter defibrillators in patients with left ventricular assist devices

Pettit, S. J., Petrie, M. C. , Connelly, D. T., Japp, A. G., Payne, J. R., Haj-Yahia, S. and Gardner, R. S. (2012) Use of implantable cardioverter defibrillators in patients with left ventricular assist devices. European Journal of Heart Failure, 14(7), pp. 696-702. (doi:10.1093/eurjhf/hfs062) (PMID:22547745)

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Abstract

Patients with left ventricular assist devices (LVADs) are at high risk of sustained ventricular arrhythmias, but these may be remarkably well tolerated and the association with sudden death is unclear. Many patients who receive an LVAD already have an implantable cardioverter defibrillator (ICD). While it is standard practice to reactivate a previously implanted ICD in an LVAD recipient, this should include discussion of the revised risks and benefits of ICD therapy following LVAD implantation. In particular, patients should be warned that they might receive a significant number of ICD shocks that may not be life saving. When ICDs are reactivated, device programming should minimize the risk of repeated shocks for non-sustained or well-tolerated ventricular arrhythmias. Implantation of a primary prevention ICD after implantation of an LVAD is not supported by current evidence, poses potential risks, and should be the subject of a clinical trial before it becomes standard practice.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Petrie, Professor Mark and Gardner, Professor Roy and Haj-Yahia, Professor Saleem and Connelly, Dr Derek
Authors: Pettit, S. J., Petrie, M. C., Connelly, D. T., Japp, A. G., Payne, J. R., Haj-Yahia, S., and Gardner, R. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:18 February 2014

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