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Updated: Jul 12, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Impact of ICD Presence in Patients With Left Ventricular Assist Devices for End-Stage Heart Failure

Nafilah Baridwan1, Mustafa Gerçek2, Muhammed Gerçek3

  • 1Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Bad Oeynhausen, Germany.

Pacing and Clinical Electrophysiology : PACE
|July 11, 2026
PubMed

Insights

Implantable cardioverter defibrillator (ICD) therapy may reduce mortality in patients with left ventricular assist devices (LVADs). However, careful consideration of complications and individual patient factors is crucial for management decisions.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • The prognostic value of implantable cardioverter defibrillators (ICDs) in patients with end-stage heart failure (HF) supported by left ventricular assist devices (LVADs) is debated.
  • Evaluating the impact of ICDs and their complications in LVAD patients is essential for optimizing care.

Purpose of the Study:

  • To assess the prognostic significance of continued ICD use in patients with LVAD implantation.
  • To identify and analyze complications associated with ICDs in this patient population.

Main Methods:

  • Retrospective analysis of 351 patients undergoing LVAD implantation between 2009 and 2021.
  • Propensity score matching created comparable cohorts of 79 patients each, with and without ICDs.
  • Primary endpoint: composite of all-cause mortality and heart transplantation; secondary endpoints included complications.

Main Results:

  • The ICD cohort showed a significantly lower rate of the primary endpoint (44.3% vs. 59.5%, p=0.035), primarily driven by reduced all-cause mortality (22.08% vs. 41.8%, p=0.008).
  • Heart transplantation rates were similar between groups (17.7% vs. 21.5%, p=0.98).
  • ICD-related complications occurred in 20.4% of patients, including lead revisions, system removals due to infection, inappropriate shocks, and hematomas.

Conclusions:

  • ICD therapy was associated with decreased mortality in this LVAD cohort, contrasting with some meta-analyses.
  • The significant occurrence of ICD complications necessitates individualized management strategies.
  • Treatment decisions should balance arrhythmic risk, pacing needs, procedural risks, and patient preferences.
Abstract

Keywords:
end‐stage heart failureimplantable cardioverter‐defibrillatorleft ventricular assist device

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