Subcutaneous Implantable Cardioverter-Defibrillator and Left Ventricular Assist Device

Migliore, Federico; Leoni, Loira; Bottio, Tomaso; Siciliano, Mariachiara; Ferretto, Sonia; Gerosa, Gino; Iliceto, Sabino; Bertaglia, Emanuele

doi:10.1016/j.jacep.2015.10.008

Cited by 11 publications

(5 citation statements)

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“…Also, there is a likely assertation bias because normal functioning devices are unlikely to be reported. In this regard, we only found three such reports of S‐ICD with confirmed lack of EMI in the literature 36‐38 . It is noteworthy that the largest published patient series of LVADs and S‐ICDs demonstrated that 10% of the patients (2/20) experienced EMI from LVADs 14 .…”

Section: Limitationsmentioning

confidence: 88%

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Ishida

Payne

Field

et al. 2020

Cardiovasc electrophysiol

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Introduction: Interactions of left ventricular assist devices (LVADs) with transvenous implantable cardioverter-defibrillator systems (ICDs) have been widely reported. However, less is known regarding the impact of electromagnetic interference (EMI) from LVADs on subcutaneous ICD function.Methods and Results: A comprehensive literature search was performed on PubMed, Cochrane central registry, and Google Scholar using the search terms "subcutaneous implantable cardioverter-defibrillator and left ventricular assist devices," "electromagnetic interference, LVAD, and subcutaneous ICD," "EMI and S-ICD," and "inappropriate shocks, LVAD, and ICD." Demographic and programming data were extracted from the reports and authors as needed. A total of seven cases of EMI in LVAD patients with subcutaneous ICD (S-ICD) devices were found. In addition three previously unreported cases from our center were included. All cases involved either a heartware ventricular assist device or HeartMate III LVAD with a pre-existing S-ICD. In all patients, both the primary and secondary vectors had inappropriate sensing due to EMI. Three patients were reprogramed to the alternate vector with appropriate sensing. The S-ICD was either inactivated or replaced with a transvenous device in six patients. A single patient was left sensing in the alternate vector. There were no reports of inability to interrogate S-ICD systems in patients with LVADs. Conclusion:The risk of inappropriate shocks from LVADs should be considered in pre-existing patients with S-ICD, particularly when the heartware ventricular assist device or HeartMate III LVAD device is present. Reprogramming of the sensing vector can occasionally avoid this issue but often the S-ICD needs to be inactivated. K E Y W O R D S electromagnetic interference, inappropriate shock, left ventricular assist device, oversensing, subcutaneous implantable cardioverter-defibrillator

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Section: Limitationsmentioning

confidence: 88%

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Ishida

Payne

Field

et al. 2020

Cardiovasc electrophysiol

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“…Electromagnetic interference were not observed in patients with HeartMate II™ and Jarvik 2000 ® 7 , 8 , 10 as opposed to patients with HeartWare ® 6 , 11 and HeartMate 3™ 9 , 12 . S-ICD algorithms for EMI discrimination have not been modified in the three generations of this device, suggesting that the occurrence of disturbances in S-ICD sensing depends on the type of LVAD implanted.…”

Section: Discussionmentioning

confidence: 91%

“…All reported patients with EMI detection had thoracic LVAD pump location, 6 , 9 , 11 , 12 while two out of three cases with a correct cardiac signal detection had a Heart Mate II™, which pump is contained in a subdiaphragmatic pocket ( Figure 4 ). 7 , 8 A patient with a Jarvik 2000 ® , 10 with the pump located in the thorax, did sense correctly. Noteworthy, this latter device runs at a very high rate, which makes sensing of EMI less likely.…”

Section: Discussionmentioning

confidence: 96%

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Subcutaneous implantable cardioverter defibrillators in patients with left ventricular assist devices: case report and comprehensive review

López‐Gil

Fontenla

Delgado

et al. 2019

European Heart Journal - Case Reports

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Background Left ventricular assist devices (LVAD) are increasingly used in patients with advanced heart failure, many of whom have been or will be implanted with an implantable cardioverter defibrillator (ICD). Interaction between both devices is a matter of concern. Subcutaneous ICD (S-ICD) obtains its signals through subcutaneous vectors, which poses special challenges with regards to adequate performance following LVAD implantation. Case summary We describe the case of a 24-year-old man implanted with an S-ICD because of idiopathic dilated cardiomyopathy, severe biventricular dysfunction, and self-limiting sustained ventricular tachycardias. After the implantation of a HeartMate 3™ (Left Ventricular Assist System, Abbott) several months later, the S-ICD became useless because of inappropriate sensing due to electromagnetic interference and attenuation of QRS voltage. Discussion We reviewed the reported cases in PubMed about the concomitant use of S-ICD and LVAD. Seven case reports about the performance of S-ICD in patients with an LVAD were identified, with discordant results. From these articles, we analyse the potential causes for these differing results. Pump location and operating rates in LVAD, as well as changes in the subcutaneous-electrocardiogram detected by the S-ICD after LVAD implantation are related to sensing disturbances when used in the same patient.

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“…However, there are emerging and encouraging data demonstrating that S-ICD, if all sensing vectors before and after LVAD activation are correctly tested or its speed increases, is a safe and effective alternative to conventional ICD in terminating ventricular arrhythmias without evidence of mechanical interferences also with different types of LVAD. 12,14 A potential limitation of this novel technique could be a potential greater complexity for battery replacement. However, we believe that both the long battery duration of the current new-generation S-ICD system and reduction of acute and late complications may overcome this potential limitation.…”

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confidence: 99%

Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heart failure: a feasible alternative to transvenous device?

et al. 2018

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Subcutaneous Implantable Cardioverter-Defibrillator and Left Ventricular Assist Device

Cited by 11 publications

References 0 publications

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Subcutaneous implantable cardioverter defibrillators in patients with left ventricular assist devices: case report and comprehensive review

Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heart failure: a feasible alternative to transvenous device?

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