Document Detail


Effect of left ventricular assist device placement on preexisting implantable cardioverter-defibrillator leads.
MedLine Citation:
PMID:  20350700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The left ventricular assist device (LVAD) is a therapy for patients with end-stage heart failure, many of whom have a preexisting implantable cardioverter-defibrillator (ICD). We investigated whether the implantation of a LVAD affects ICD function. METHODS AND RESULTS: Patients implanted with a LVAD between September 2000 and February 2009 were studied. Right ventricular (RV), right atrial, and left ventricular lead impedance, sensing, and capture thresholds were recorded before and after LVAD placement and subsequent lead-related interventions were noted. Of the 61 patients receiving a LVAD, data were collected from 30 patients who had preexisting ICDs. Significant pre-post differences were noted for all RV lead parameters: sensing amplitude decreased from 9.2+/-3.1 to 5.7+/-3.6 millivolts (P < .001); impedance decreased from 479+/-118 to 418+/-94 ohms (P=.008); and threshold increased from 4.3+/-6.7 to 11.0+/-16.8 microjoules (P=.021). As a result of alterations in lead parameters, 4 patients (13%) required lead revisions and 6 patients (20%) required ICD testing. CONCLUSIONS: Differences in ICD lead function were observed after LVAD placement resulting in clinically significant interventions. These data suggest that ICD interrogation be performed post-LVAD placement and that patients be counseled for the potential need for lead revisions and ICD testing when consented for a LVAD.
Authors:
Amrut V Ambardekar; Christopher M Lowery; Larry A Allen; Anne P Cannon; Joseph C Cleveland; Joann Lindenfeld; Andreas Brieke; William H Sauer
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-08
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-31     Citation Subset:  IM    
Copyright Information:
(c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiology and Cardiothoracic Surgery, University of Colorado Denver, Aurora, CO 80045, USA. Amrut.Ambardekar@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Defibrillators, Implantable* / standards
Female
Follow-Up Studies
Heart-Assist Devices* / standards
Humans
Male
Middle Aged
Retrospective Studies
Ventricular Dysfunction, Left / physiopathology,  surgery,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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