Key result
Among patients with a left ventricular assist device, 73.3% were eligible for subcutaneous implantable cardioverter-defibrillator implantation based on ECG or automated screening tests.
Why the study?
Surface ECG is altered after LVAD implantation, which could potentially affect S-ICD detection since it relies on surface ECG.
Does S-ICD screening demonstrate eligibility in patients with left ventricular assist devices?
Observational (n=75)
No
Does S-ICD screening demonstrate eligibility in patients with left ventricular assist devices?
In patients with an LVAD, 73.3% were eligible for S-ICD implantation based on screening tests, suggesting it may be a feasible alternative to transvenous ICDs despite lower eligibility rates than the general heart failure population.
PURPOSE: The subcutaneous implantable cardioverter-defibrillator (S-ICD) could be a promising alternative to the conventional transvenous ICD in patients with LVAD due to its reduced risk of infection. However, surface ECG is altered following LVAD implantation and, since S-ICD detection is based on surface ECG, S-ICD could be potentially affected. The aim of the present study was to analyze S-ICD eligibility in patients with LVAD. METHODS: Seventy-five patients implanted with an LVAD were included in this prospective single-center study. The ECG-based screening test and the automated screening test were performed in all patients. RESULTS: Fifty-five (73.3%) patients had either a positive ECG-based or automated screening test. Out of these, 28 (37.3%) patients were found eligible for S-ICD implantation with both screening tests performed. ECG-based screening test was positive in 50 (66.6%) patients; automated screening test was positive in 33 (44.0%) patients. Three ECG-based screening tests could not be evaluated due to artifacts. With the automated screening test, in 9 (12.0%) patients, the test yielded no result. CONCLUSIONS: Patients implanted with an LVAD showed lower S-ICD eligibility rates compared with patients without LVAD. With an S-ICD eligibility rate of maximal 73.3%, S-ICD therapy may be a feasible option in these patients. Nevertheless, S-ICD implantation should be carefully weighed against potential device-device interference. Prospective studies regarding S-ICD eligibility before and after LVAD implantation are required to further elucidate the role of S-ICD therapy in this population.
No takes yet. Share an insight, caveat, or question.
Zormpas et al. (2020) conducted an observational in Left ventricular assist device (LVAD) (n=75). Left ventricular assist device (LVAD) was evaluated on S-ICD eligibility (positive ECG-based or automated screening test). Among patients with a left ventricular assist device, 73.3% were eligible for subcutaneous implantable cardioverter-defibrillator implantation based on ECG or automated screening tests.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: