[Ventricular assist devices in Iceland 2010-2024]

Ventricular assist devices are increasingly used as a treatment option for patients with advanced heart failure, however, there is a lack of information about the number of patients, indications, and outcomes of this patient population in Iceland.

A retrospective study covering the period 01.01.2020 - 31.12.2024. The study population consisted of individuals who had received a ventricular assist device and had received treatment or follow-up care in Iceland either before or after implantation of the ventricular assist device. Clinical data were obtained from electronic medical records, and variables were collected before and after implantation.

Between 2010 and 2024, six individuals received a ventricular assist device (VAD), all of whom were male. The age at implantation ranged from 17 to 66 years. Indications for VAD implantation were equally divided between bridge to transplantation (3/6) and bridge to candidacy (3/6). The underlying causes of heart failure were dilated cardiomyopathy (5/6) and ischemic cardiomyopathy (1/6). Four patients received a left ventricular assist device, while two received a biventricular assist device. Four patients subsequently underwent heart transplantation, one died while on VAD support, and one remained on VAD therapy at the end of the study period. The mean time from VAD implantation to heart transplantation was 249 days. Throughout the study period, there were a total of 1704 days on which at least one patient with a VAD was located in Iceland, corresponding to 31% of the study period. Four complications were documented in three patients: driveline infection, ventricular tachycardia, gastrointestinal bleeding and subarachnoid hemorrhage due to syncope.

Patients with VADs were effectively managed in Iceland, and the results imply that the use of VADs possibly represents a currently underutilized therapeutic option for advanced heart failure in Iceland.