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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Impact of digoxin utilization on clinical outcomes following left ventricular assist device implantation

Muhannad Aboud Abbasi1, Douglas A Stoller1, Elizabeth Lyden2

  • 1Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

The International Journal of Artificial Organs
|August 10, 2022
PubMed

Insights

Digoxin use after left ventricular assist device (LVAD) implantation significantly reduced gastrointestinal bleeding events. However, it did not impact right ventricular failure or overall survival in patients with LVADs.

Area of Science:

  • Cardiology
  • Medical Devices
  • Pharmacology

Background:

  • Left ventricular assist devices (LVADs) are crucial for end-stage heart failure management.
  • Optimizing medical therapy post-LVAD implantation is essential for improving patient outcomes.
  • The role of digoxin in patients with LVADs requires further investigation.

Purpose of the Study:

  • To evaluate the clinical impact of digoxin use in patients following LVAD implantation.
  • To determine if digoxin affects key adverse events such as gastrointestinal bleeding and right ventricular failure.
  • To assess the association between digoxin use and long-term survival after LVAD.

Main Methods:

  • Retrospective analysis of 346 patients who received continuous flow LVADs.
  • Digoxin use defined as 30-day continuous use post-LVAD implantation.
  • Kaplan-Meier and negative binomial regression used to analyze clinical outcomes over 2 years.

Main Results:

  • Digoxin use (41.6% of patients) was associated with a significant 47% reduction in gastrointestinal bleeding (GIB) incidence.
  • No significant difference in the incidence of right ventricular failure (RVF) was observed between digoxin users and non-users.
  • Overall 2-year survival rates were similar for patients who did and did not use digoxin.

Conclusions:

  • Digoxin use post-LVAD implantation is linked to a reduced incidence of GIB.
  • Digoxin does not appear to influence RVF or mortality in this patient cohort.
  • Further research is warranted to confirm these findings and explore optimal digoxin use strategies.
Abstract

Keywords:
Digoxingastrointestinal bleedingleft ventricular assist deviceright ventricular failure

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