Related Experiment Video
Updated: Mar 18, 2026
Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
Implantable Cardioverter-Defibrillator Use in Patients With Left Ventricular Assist Devices: A Systematic Review and
Kairav Vakil1, Felipe Kazmirczak2, Neeraj Sathnur2
1Division of Cardiology, Veterans Affairs Medical Center, Minneapolis, Minnesota; Division of Cardiology, University of Minnesota, Minneapolis, Minnesota.
Insights
Implantable cardioverter-defibrillators (ICDs) significantly reduce mortality in left ventricular assist device (LVAD) patients. However, this survival benefit was not observed in patients with continuous-flow LVADs, warranting further research.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Research
Background:
- Ventricular arrhythmias pose a significant risk for patients with left ventricular assist devices (LVADs).
- Previous research on the impact of implantable cardioverter-defibrillators (ICDs) on LVAD patient survival has produced inconsistent findings.
Purpose of the Study:
- To systematically review and meta-analyze published studies evaluating the effect of ICDs on mortality in LVAD recipients.
- To clarify the role of ICDs in improving survival rates for patients with LVADs, particularly considering different LVAD types.
Main Methods:
- A systematic review and meta-analysis of observational studies published between January 2000 and October 2015.
- Studies were identified using PubMed and OVID databases.
- Weighted relative risks for mortality were calculated using random effects meta-analysis techniques.
Main Results:
- Six studies comprising 937 patients were included; 38% had an ICD.
- Overall, ICD presence was associated with a significant 39% relative risk reduction in all-cause mortality (RR: 0.61; p < 0.01).
- In the subgroup of patients with continuous-flow LVADs (n=361), ICD use showed a non-significant trend toward improved survival (RR: 0.76; p = 0.17).
Conclusions:
- ICD use is linked to a significant reduction in mortality for LVAD patients.
- The survival benefit of ICDs was not statistically significant in patients with continuous-flow LVADs.
- While current data support ICD use, larger randomized trials are crucial to confirm effectiveness in contemporary LVAD populations.
Objectives:
This study evaluated the impact of implantable cardioverter-defibrillators (ICDs) on mortality in patients with left ventricular assist devices (LVADs) by conducting a systematic review and meta-analysis of published studies.
Background:
The burden of ventricular arrhythmias in patients with LVADs is high. Prior studies assessing the impact of ICD on survival of patients with LVADs have yielded conflicting results.
Methods:
Relevant studies from January 2000 through October 2015 were identified in the databases PubMed and OVID. Weighted relative risks were estimated using random effects meta-analysis techniques.
Results:
Six observational studies (n = 937) were included. Patients were 53 ± 12 years of age, and 80% were male. Bridge-to-transplantation was the indication for LVAD use in 93% of the patients. A continuous-flow (CF) LVAD was present in 39% of patients. Mean left ventricular ejection fraction was 16 ± 6%. An ICD was present in 355 patients (38%). During a mean follow-up of 7 months, 241 patients (26%) died (16% in the ICD group vs. 32% in the no-ICD group). Presence of an ICD was associated with a 39% relative risk reduction in all-cause mortality (RR: 0.61; 95% confidence interval [CI]: 0.46 to 0.82; p < 0.01). Among subgroup of patients with CF-LVAD (n = 361), ICD use was associated with a statistically nonsignificant trend toward improved survival (RR: 0.76; 95% CI: 0.51 to 1.12; p = 0.17).
Conclusions:
ICD use was associated with a significant reduction in mortality in LVAD patients, however, this effect was not significant in patients with CF-LVADs. Although these data support the use of ICDs, larger randomized trial data are strongly warranted to evaluate ICD effectiveness in patients with current generation LVADs.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:24Cardiac Catheterization III: Left Heart Catheterization
01:22Heart Failure VI: Adjunct Therapies
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:23Cardiopulmonary Resuscitation III: AED Use
01:21Cardiac Catheterization II: Right Heart Catheterization