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Impact of Cardiac Resynchronization Therapy on Ventricular Arrhythmias and Survival After Durable Left Ventricular

Connor P Oates1,2, Luke L Lawrence1,2, Grace E Bigham1,2

  • 1From the MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 29, 2024
PubMed

Insights

Turning "on" cardiac resynchronization therapy (CRT) after left ventricular assist device (LVAD) implantation increased mortality risk. Further trials are needed to optimize CRT programming for LVAD patients.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) impact post-left ventricular assist device (LVAD) implantation is unclear.
  • No consensus exists on optimal postoperative CRT management in LVAD patients.

Purpose of the Study:

  • To evaluate the effect of postoperative CRT management on clinical outcomes after LVAD implantation.
  • To determine if CRT programmed 'on' or 'off' impacts patient survival and ventricular arrhythmias.

Main Methods:

  • Retrospective analysis of 789 patients undergoing LVAD implantation (2007-2022).
  • Comparison of outcomes between patients with preoperative CRT programmed 'on' versus 'off' post-LVAD.
  • Analysis included mortality risk and incidence of ventricular arrhythmias.

Main Results:

  • Patients with preoperative CRT programmed 'on' post-LVAD had significantly increased mortality risk (sdHR=1.54; p=0.036).
  • No significant difference in ventricular arrhythmia incidence between postoperative CRT 'on' and 'off' groups (p=0.095).
  • Preoperative CRT patients were older and more likely to receive LVAD for destination therapy.

Conclusions:

  • Postoperative CRT programming 'on' is associated with increased mortality in LVAD patients.
  • Further clinical trials are essential to establish optimal CRT programming strategies for LVAD recipients.

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