Long-Term Implantable Cardioverter Defibrillator Lead Dysfunction After Left Ventricular Assist Device Implantation.

Area of Science:

• Cardiology
• Medical Devices
• Heart Failure Management

Background:

• Implantable cardioverter defibrillator (ICD) lead dysfunction is a known complication after left ventricular assist device (LVAD) implantation.
• Previous studies have primarily focused on short-term outcomes of this complication.

Purpose of the Study:

• To evaluate the long-term incidence of ICD lead dysfunction following LVAD implantation.
• To characterize the nature of lead dysfunction (persistent vs. temporary).
• To identify predictors of persistent ICD lead dysfunction after LVAD implantation.

Main Methods:

• Retrospective multicenter study.
• Inclusion of patients with transvenous ICD leads at the time of LVAD implantation (2011-2023).
• Logistic analysis to determine risk factors for persistent vs. temporary lead dysfunction.

Main Results:

• Lead dysfunction occurred in 72.9% of 170 patients over a median follow-up of 46.2 months.
• Persistent dysfunction accounted for 67.7% of the 124 lead dysfunction events.
• Dysfunction occurring later than 2.1 months post-LVAD implantation was an independent risk factor for persistent lead dysfunction (OR: 4.67).

Conclusions:

• ICD lead dysfunction is highly prevalent and often persistent after LVAD implantation.
• Late-onset lead dysfunction (>2 months post-LVAD) is a significant predictor of persistent dysfunction.
• These findings highlight the need for vigilant monitoring of ICD leads in LVAD patients.