Heart failure

Heart Failure Devices: Answers From the Heart Rhythm Scientific Sessions

Advanced heart failure (HF) is treatable with surgery. Among the most common devices used are implantable cardioverter defibrillators (ICDs) and continuous flow left ventricular assist devices (CFLVADs).

At the Heart Rhythm Scientific Sessions 2018, Dr Jaimin Trivedi and colleagues presented their research titled “Role of Implantable Cardioverter Defibrillator In End-stage Heart Failure Patients Listed For Transplant in the Continuous Flow Left Ventricular Assist Device Era.”1

Jaimin Trivedi, MD, MPH, is an Assistant Professor in the Department of Cardiovascular and Thoracic Surgery at the University of Louisville in Kentucky.

 

 

Consultant360: What were your conclusions after analyzing the data from your study, and how will your results impact thoracic surgeons in the field?

Dr Jaimin Trivedi: The end-stage HF patients listed for heart transplant are often treated with ICD. The CFLVAD has been increasingly used to treat these advanced HF patients in recent years. Our study focused on impact of ICD on waiting list survival of patients with and without CFLVAD.

We found that, in patients with CFLVAD, use of ICD does not offer any waiting list survival advantage. However, in patients not supported by CFLVAD, use of ICD was associated with improved waiting list survival.

C360: Were there any differences in outcomes between older vs younger patients, or patients of different ethnicities?

JT: We did not specifically seek to answer questions about impact of demographic variables (age, gender, ethnicity, etc) on waiting list survival outcomes. However, we found that patients who had ICD were older compared to non-ICD patients (median: 55 years vs 52 years).

C360: What are the unanswered questions that you plan to research?

JT: Since this was a registry data study, several factors such as status of ICD (turned on vs off), ICD vs cardiac resynchronization therapy device, presence of certain arrhythmia, and so on could not be accounted for. We are currently working on another project to answer aforementioned limitations.

C360: What is the key takeaway you want to leave our readers with?

JT: Use of CFLVAD provides significant waiting survival advantage to patients listed for heart transplant irrespective of ICD use. However, in patients not supported by CFLVAD, use of ICD has significant waiting list survival benefit. 

 

—Amanda Balbi, managing editor, Consultant360

Reference:

  1. Trivedi J, Slaughter M, Vijaykrishnan R, Gopinathannair R. Role of implantable cardioverter defibrillator in end-stage heart failure patients listed for transplant in the continuous flow left ventricular assist device era. Paper presented at: Heart Rhythm Scientific Sessions; May 9-12, 2018; Boston, MA. http://abstractsonline.com/pp8/#!/4554/presentation/6002. Accessed May 1, 2018.