Atrial Arrhythmias Significantly Affect Outcomes in LVAD Recipients

In patients with continuous flow left ventricular assist devices (LVAD), pre-LVAD atrial arrhythmia (AA) were associated with significantly higher incidence of post-LVAD AA, as the  well as reduced survival.

The researchers came to this conclusion following a study involving 537 patients who underwent LVAD implantation from 2007 to 2015. AA was defined as atrial flutter or atrial fibrillation lasting > 6 hours or ≥1% burden on device interrogation or requiring pharmacological or electrical cardioversion.

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The study was the first real world, multicenter study to assess outcomes associated with AA in LVAD patients, according to the authors.

Of the 537 patients, 234 had pre-LVAD AA and 303 did not. Pre-LVAD AA patients were older at baseline and had more ventricular arrhythmias but less hypertension and Implantable cardioverter-defibrillators. Compared with participants without pre-LVAD AA, those with pre-LVAD AA had higher incidence of post-LVAD AA (72% vs 41%) and vascular arrhythmias (65% vs 52%) but similar rates of hospitalization. All-cause mortality was significantly higher in patients with pre-LVAD AA than in those without.

“In this large, multicenter LVAD cohort, pre-LVAD AA was associated with a significantly higher incidence of post-LVAD AA and ventricular arrhythmias. Pre-LVAD AA was associated with reduced survival in LVAD recipients,” the researchers concluded.

—Michael Potts

Reference:

Gopinathannair R, Trivedi J, Bhan AK et al. Atrial Arrhythmias and clinical outcomes in continuous flow LVAD recipients: a multicenter analysis [presented at the 2018 Heart Rhythm Scientific Sessions]. May 10, 2018.