Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis.
<h4>Background</h4>The number of left ventricular assist devices (LVADs) implanted in patients with end-stage heart failure is increasing. In this patient cohort, subcutaneous implantable cardioverter defibrillators (S-ICDs) could be a promising alternative to transvenous ICDs due to low...
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Public Library of Science (PLoS)
2023-01-01
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Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0284419 |
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author | Christos Zormpas Johanna Mueller-Leisse Stephan Hohmann Jörg Eiringhaus Henrike Aenne Katrin Hillmann Jan D Schmitto Christian Veltmann David Duncker |
author_facet | Christos Zormpas Johanna Mueller-Leisse Stephan Hohmann Jörg Eiringhaus Henrike Aenne Katrin Hillmann Jan D Schmitto Christian Veltmann David Duncker |
author_sort | Christos Zormpas |
collection | DOAJ |
description | <h4>Background</h4>The number of left ventricular assist devices (LVADs) implanted in patients with end-stage heart failure is increasing. In this patient cohort, subcutaneous implantable cardioverter defibrillators (S-ICDs) could be a promising alternative to transvenous ICDs due to lower infection rates and avoidance of venous access. However, eligibility for the S-ICD depends on ECG features that may be influenced by an LVAD. The aim of the present study was a prospective evaluation of S-ICD eligibility before and after LVAD implantation.<h4>Methods</h4>The study recruited all patients presenting at Hannover Medical School for LVAD implantation between 2016 and 2020. S-ICD eligibility was evaluated using the ECG-based and the device-based S-ICD screening test before and after LVAD implantation.<h4>Results</h4>Twenty-two patients (57.3 ± 8.7 years of age, 95.5% male) were included in the analysis. The most common underlying diseases were dilated cardiomyopathy (n = 16, 72.7%) and ischemic cardiomyopathy (n = 5, 22.7%). Before LVAD implantation 16 patients were found eligible for the S-ICD according to both screening tests (72.7%), but only 7 patients were eligible after LVAD, 31.8%; p = 0.05). Oversensing due to electromagnetic interference was observed in 6 patients (66.6%) found ineligible for S-ICD after LVAD implantation. A lower S wave amplitude in leads I (p = 0.009), II (p = 0.006) and aVF (p = 0.006) before LVAD implantation was associated with higher rate of S-ICD ineligibility after LVAD implantation.<h4>Conclusion</h4>LVAD implantation can impair S-ICD eligibility. Patients with lower S wave amplitude in leads I, II and aVF were more likely to be ineligible for S-ICD implantation after LVAD implantation. Thus, S-ICD therapy should be carefully considered in patients who are candidates for LVAD therapy. |
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institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-04-09T15:53:36Z |
publishDate | 2023-01-01 |
publisher | Public Library of Science (PLoS) |
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series | PLoS ONE |
spelling | doaj.art-fa726791a0044b58a95a36cbba54c4fe2023-04-26T05:31:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184e028441910.1371/journal.pone.0284419Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis.Christos ZormpasJohanna Mueller-LeisseStephan HohmannJörg EiringhausHenrike Aenne Katrin HillmannJan D SchmittoChristian VeltmannDavid Duncker<h4>Background</h4>The number of left ventricular assist devices (LVADs) implanted in patients with end-stage heart failure is increasing. In this patient cohort, subcutaneous implantable cardioverter defibrillators (S-ICDs) could be a promising alternative to transvenous ICDs due to lower infection rates and avoidance of venous access. However, eligibility for the S-ICD depends on ECG features that may be influenced by an LVAD. The aim of the present study was a prospective evaluation of S-ICD eligibility before and after LVAD implantation.<h4>Methods</h4>The study recruited all patients presenting at Hannover Medical School for LVAD implantation between 2016 and 2020. S-ICD eligibility was evaluated using the ECG-based and the device-based S-ICD screening test before and after LVAD implantation.<h4>Results</h4>Twenty-two patients (57.3 ± 8.7 years of age, 95.5% male) were included in the analysis. The most common underlying diseases were dilated cardiomyopathy (n = 16, 72.7%) and ischemic cardiomyopathy (n = 5, 22.7%). Before LVAD implantation 16 patients were found eligible for the S-ICD according to both screening tests (72.7%), but only 7 patients were eligible after LVAD, 31.8%; p = 0.05). Oversensing due to electromagnetic interference was observed in 6 patients (66.6%) found ineligible for S-ICD after LVAD implantation. A lower S wave amplitude in leads I (p = 0.009), II (p = 0.006) and aVF (p = 0.006) before LVAD implantation was associated with higher rate of S-ICD ineligibility after LVAD implantation.<h4>Conclusion</h4>LVAD implantation can impair S-ICD eligibility. Patients with lower S wave amplitude in leads I, II and aVF were more likely to be ineligible for S-ICD implantation after LVAD implantation. Thus, S-ICD therapy should be carefully considered in patients who are candidates for LVAD therapy.https://doi.org/10.1371/journal.pone.0284419 |
spellingShingle | Christos Zormpas Johanna Mueller-Leisse Stephan Hohmann Jörg Eiringhaus Henrike Aenne Katrin Hillmann Jan D Schmitto Christian Veltmann David Duncker Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. PLoS ONE |
title | Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. |
title_full | Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. |
title_fullStr | Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. |
title_full_unstemmed | Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. |
title_short | Changes in eligibility for a subcutaneous cardioverter-defibrillator after implantation of a left ventricular assist device-A prospective analysis. |
title_sort | changes in eligibility for a subcutaneous cardioverter defibrillator after implantation of a left ventricular assist device a prospective analysis |
url | https://doi.org/10.1371/journal.pone.0284419 |
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