Key result
Novel device-based screening detects S-ICD interference in ~12% of LVAD patients cleared by standard ECG.
Why the study?
S-ICD eligibility is lower in patients with LVAD than in those without, and inappropriate S-ICD therapy due to device interference has been reported in this population.
Does a novel device-based screening test improve identification of potential interference between S-ICD and LVAD compared to standard ECG-based screening in patients with LVAD?
Cross-Sectional (n=115)
Does a novel device-based screening test improve identification of potential interference between S-ICD and LVAD compared to standard ECG-based screening in patients with LVAD?
A novel device-based screening test identifies potential S-ICD and LVAD interference in 12% of patients who would otherwise be deemed eligible by standard ECG screening.
S-ICD screening may be warranted pre-LVAD; leaves open optimal ICD strategy in this population.
INTRODUCTION: In patients with a left ventricular assist device (LVAD), the subcutaneous implantable cardioverter-defibrillator (S-ICD) can be an alternative to transvenous ICD systems due to reduced risk of systemic infection, which could lead to extraction of the ICD as well as the LVAD. S-ICD eligibility is lower in patients with LVAD than in patients with end-stage heart failure without LVAD. Several reports have shown inappropriate S-ICD therapy in the coexistence of LVAD and S-ICD. The aim of the present study was to evaluate S-ICD eligibility in patients with LVAD using the established electrocardiogram (ECG)-based screening test as well as a novel device-based screening test to identify potentially inappropriate S-ICD sensing in this specific patient cohort. METHODS AND RESULTS: The present study included 115 patients implanted with an LVAD. The standard ECG-based screening test and a novel device-based screening test were performed in all patients. Eighty patients (70%) were eligible for S-ICD therapy with the standard ECG-based screening test. Performance of the novel device-based screening test identified device-device interference in 14 of these 80 patients (12%). CONCLUSION: Using a novel extended device-based S-ICD screening method, a small number of patients with LVAD deemed eligible for S-ICD with the standard ECG-based screening test exhibit device-device interference. Careful S-ICD screening should be performed in patients with LVAD, who are candidates for S-ICD therapy, to prevent inappropriate sensing or ICD therapy.
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Zormpas et al. (2020) conducted a cross-sectional in Left ventricular assist device (LVAD) (n=115). Novel device-based screening test vs. Standard ECG-based screening test was evaluated on Device-device interference. A novel device-based screening test identified device-device interference in 12% of LVAD patients who were deemed eligible for S-ICD therapy by the standard ECG-based screening test.
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