Presence of Implantable Cardioverter-Defibrillators and Wait-List Mortality of Patients Supported with Left Ventricular Assist Devices as Bridge to Heart Transplantation

Cardiac implantable electronic devices with a defibrillator component and all‐cause mortality in left ventricular assist device carriers: results from the PCHF‐VAD registry

“…However, the rate of all‐cause death in our multicentre cohort, and in particular the subgroup without CIED‐D post‐LVAD, was notably higher in comparison to this single‐centre study, yet lower than reported from the EUROMACS data, and similar to the INTERMACS report . In an analysis of the UNOS registry, the presence of ICDs at listing in durable LVAD recipients was not associated with lower waitlist mortality; however, numerically fewer arrhythmic deaths were noted in the ICD group . As mentioned, the penetration of ICDs in this cohort is notably greater than in our European cohort which may portend differences among the populations.…”

Implantable cardioverter‐defibrillator therapy in patients with left ventricular assist devices: a shocking tale of survival

“…One of the most notable differences between patients treated at European centres compared to patients included in US-based studies is the significantly lower baseline ICD use in Europe compared to the US, with only 47% baseline ICD use in the present study compared to greater than 80% baseline ICD use in INTERMACS and UNOS registry analyses from the US. 4,7 The lower ICD use in the European population is likely driven by fewer ICDs implanted for primary prevention in Europe as reported previously. 2 In the present study, only 34% of patients had an ICD implanted for primary prevention.…”

“…Results of prior retrospective studies of the mortality benefit of ICDs in patients with continuous-flow LVADs are variable. [4][5][6][7] For the most part, these studies from US patient populations have not shown a survival benefit of ICDs in the LVAD population. The largest studies compared propensity-score matched populations from data collected in the US INTERMACS registry and showed no benefit from ICD therapy.…”

“…Results of prior retrospective studies of the mortality benefit of ICDs in patients with continuous‐flow LVADs are variable . For the most part, these studies from US patient populations have not shown a survival benefit of ICDs in the LVAD population.…”

Implantable Cardioverter-defibrillator Therapy in the Patient with a Left Ventricular Assist Device: Still a Black Box

“…In their investigation, 722 patients with an ICD were compared with 722 patients without ICD, and no association between decreased waitlist mortality and ICD use was found. 17 In summary, while the largest analysis of available data suggests a survival benefit associated with ICD therapy in LVAD patients, more recent data that likely better represent ''today's'' LVAD patient do not corroborate this conclusion. Thus, we are left with uncertainty regarding the benefit of ICD therapy in these patients and, certainly in some individuals (such as those with inappropriate shocks, ventricular tachycardia storm, or cardiovascular implantable electronic device-associated infection), indications that the ICD may do more harm than good.…”