title: Effect of Continued Cardiac Resynchronization Therapy on Ventricular Arrhythmias After Left Ventricular Assist Device Implantation.
abstract: Cardiac resynchronization therapy (CRT) reduces ventricular arrhythmia (VA) burden in some patients with heart failure, but its effect after left ventricular assist device (LVAD) implantation is unknown. We compared VA burden in patients with CRT devices in situ who underwent LVAD implantation and continued CRT (n = 39) to those who had CRT turned off before discharge (n = 26). Implantable cardioverter-defibrillator (ICD) shocks were significantly reduced in patients with continued CRT (1.5 ± 2.7 shocks per patient vs 5.5 ± 9.3 with CRT off, p = 0.014). There was a nonsignificant reduction in cumulative VA episodes per patient with CRT continued at discharge (42 ± 105 VA per patient vs 82 ± 198 with CRT off, p = 0.29). On-treatment analysis by whether CRT was on or off identified a significantly lower burden of VA (17 ± 1 per patient-year CRT on vs 37 ± 1 per patient-year CRT off, p <0.0001) and ICD shocks (1.2 ± 0.3 per patient-year CRT on vs 1.7 ± 0.3 per patient-year CRT off, p = 0.018). In conclusion, continued CRT is associated with significantly reduced ICD shocks and VA burden after LVAD implantation.
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona; Department of Cardiology and Vascular Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: John William
authors.initials: JW
authors.lastname: Schleifer
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: Farouk
authors.initials: F
authors.lastname: Mookadam
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: Evan P
authors.initials: EP
authors.lastname: Kransdorf
authors.affiliation: Department of Internal Medicine, Maricopa Medical Center, Phoenix, Arizona.
authors.forename: Udai
authors.initials: U
authors.lastname: Nanda
authors.affiliation: Department of Cardiology, North Central Heart, Avera Heart Hospital of South Dakota, Sioux Falls, South Dakota.
authors.forename: Jonathon C
authors.initials: JC
authors.lastname: Adams
authors.affiliation: Department of Research Biostatistics, Mayo Clinic Arizona, Scottsdale, Arizona.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cha
authors.affiliation: Department of Cardiac and Thoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: Octavio E
authors.initials: OE
authors.lastname: Pajaro
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: David Eric
authors.initials: DE
authors.lastname: Steidley
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Scott
authors.affiliation: Department of Anesthesiology, Mayo Clinic Arizona, Phoenix, Arizona.
authors.forename: Tomas
authors.initials: T
authors.lastname: Carvajal
authors.affiliation: Department of Cardiology and Vascular Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rayya A
authors.initials: RA
authors.lastname: Saadiq
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona. Electronic address: srivathsan.komandoor@mayo.edu.
authors.forename: Komandoor
authors.initials: K
authors.lastname: Srivathsan
mesh_terms: D000328:Adult; D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000453:epidemiology* / Q000628:therapy; D014693:Ventricular Fibrillation / Q000453:epidemiology* / Q000628:therapy