Abstract：
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.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Ambardekar AV,Lowery CM,Allen LA,Cannon AP,Cleveland JC Jr,Lindenfeld J,Brieke A,Sauer WHdoi
10.1016/j.cardfail.2009.12.003subject
Has Abstractpub_date
2010-04-01 00:00:00pages
327-31issue
4eissn
1071-9164issn
1532-8414pii
S1071-9164(09)01197-Xjournal_volume
16pub_type
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