Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support

Abstract The association between ventricular arrhythmias (VAs) and mortality in patients supported by continuous flow left ventricular assist devices (LVAD) remains controversial. To evaluate the association between pre-implantation, early (≤ 30 day) post-implantation VAs and mortality in bridge to...

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Autores principales:	Zeina Jedeon, Rebecca Cogswell, Jessica Schultz, Lisa Von Wald, Ranjit John, Henri Roukoz
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/10381bd49cd846ca8e3c4f6c5b4b2bb8
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spelling	oai:doaj.org-article:10381bd49cd846ca8e3c4f6c5b4b2bb82021-12-02T17:37:29ZAssociation between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support10.1038/s41598-021-98109-22045-2322https://doaj.org/article/10381bd49cd846ca8e3c4f6c5b4b2bb82021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98109-2https://doaj.org/toc/2045-2322Abstract The association between ventricular arrhythmias (VAs) and mortality in patients supported by continuous flow left ventricular assist devices (LVAD) remains controversial. To evaluate the association between pre-implantation, early (≤ 30 day) post-implantation VAs and mortality in bridge to transplant (BTT) and destination therapy (DT) LVAD patients, separately. The risk factors for post LVAD VAs were also investigated. In this observational cohort study, we included 341 patients who received a first time, continuous flow LVAD between January 1st 2010 and July 30th 2018. We used Kaplan–Meier curves and multivariable cox regression analyses to study the association between VAs and mortality in the BTT and DT populations. The mean age of the cohort was 58 ± 14 years, with 82% males, 53% had ischemic cardiomyopathy, and 45% were DT. The mean follow-up was 2.2 ± 2.1 years. In both BTT and DT cohorts, pre LVAD VAs were not associated with mortality after LVAD implantation (log-rank p = 0.95 and p = 0.089, respectively). In the BTT population, early post-LVAD VAs were not statistically associated with increased mortality (log rank p = 0.072). In the DT patients, early post LVAD VAs were associated with a 67% increase in the hazards rate of mortality on LVAD support (HR 1.67 [1.05–2.65], p = 0.029). The final model was adjusted for type of cardiomyopathy, INTERMACS profile, glomerular filtration rate, post LVAD atrial fibrillation, age and cerebrovascular events. Early post-LVAD VA is common after LVAD implantation and is an independent predictor of mortality in the DT LVAD population.Zeina JedeonRebecca CogswellJessica SchultzLisa Von WaldRanjit JohnHenri RoukozNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zeina Jedeon Rebecca Cogswell Jessica Schultz Lisa Von Wald Ranjit John Henri Roukoz Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
description	Abstract The association between ventricular arrhythmias (VAs) and mortality in patients supported by continuous flow left ventricular assist devices (LVAD) remains controversial. To evaluate the association between pre-implantation, early (≤ 30 day) post-implantation VAs and mortality in bridge to transplant (BTT) and destination therapy (DT) LVAD patients, separately. The risk factors for post LVAD VAs were also investigated. In this observational cohort study, we included 341 patients who received a first time, continuous flow LVAD between January 1st 2010 and July 30th 2018. We used Kaplan–Meier curves and multivariable cox regression analyses to study the association between VAs and mortality in the BTT and DT populations. The mean age of the cohort was 58 ± 14 years, with 82% males, 53% had ischemic cardiomyopathy, and 45% were DT. The mean follow-up was 2.2 ± 2.1 years. In both BTT and DT cohorts, pre LVAD VAs were not associated with mortality after LVAD implantation (log-rank p = 0.95 and p = 0.089, respectively). In the BTT population, early post-LVAD VAs were not statistically associated with increased mortality (log rank p = 0.072). In the DT patients, early post LVAD VAs were associated with a 67% increase in the hazards rate of mortality on LVAD support (HR 1.67 [1.05–2.65], p = 0.029). The final model was adjusted for type of cardiomyopathy, INTERMACS profile, glomerular filtration rate, post LVAD atrial fibrillation, age and cerebrovascular events. Early post-LVAD VA is common after LVAD implantation and is an independent predictor of mortality in the DT LVAD population.
format	article
author	Zeina Jedeon Rebecca Cogswell Jessica Schultz Lisa Von Wald Ranjit John Henri Roukoz
author_facet	Zeina Jedeon Rebecca Cogswell Jessica Schultz Lisa Von Wald Ranjit John Henri Roukoz
author_sort	Zeina Jedeon
title	Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
title_short	Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
title_full	Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
title_fullStr	Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
title_full_unstemmed	Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support
title_sort	association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow lvad support
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/10381bd49cd846ca8e3c4f6c5b4b2bb8
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Association between early ventricular arrhythmias and mortality in destination vs. bridge patients on continuous flow LVAD support

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