Skip to main content
Journal cover image

Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation.

Publication ,  Journal Article
Black-Maier, E; Lewis, RK; Rehorn, M; Loungani, R; Friedman, DJ; Frazier-Mills, C; Jackson, KP; Atwater, BD; Milano, CA; Schroder, JN ...
Published in: J Cardiovasc Electrophysiol
June 2020

INTRODUCTION: Lead dysfunction can lead to serious consequences including failure to treat ventricular tachycardia or fibrillation (VT/VF). The incidence and mechanisms of lead dysfunction following left ventricular assist device (LVAD) implantation are not well-described. We sought to determine the incidence, mechanisms, timing, and complications of right ventricular lead dysfunction requiring revision following LVAD implantation. METHODS: Retrospective observational chart review of all LVAD recipients with pre-existing implantable cardioverter-defibrillator (ICD) from 2009 to 2018 was performed including device interrogation reports, laboratory and imaging data, procedural reports, and clinical outcomes. RESULTS: Among 583 patients with an ICD in situ undergoing LVAD implant, the median (interquartile range) age was 62.5 (15.7) years, 21% were female, and the types of LVADs included HeartWare HVAD (26%), HeartMate II (52%), and HeartMate III (22%). Right ventricular lead revision was performed in 38 patients (6.5%) at a median (25th, 75th) of 16.4 (3.6, 29.2) months following LVAD. Mechanisms of lead dysfunction included macrodislodgement (n = 4), surgical lead injury (n = 4), recall (n = 3), insulation failure (n = 8) or conductor fracture (n = 7), and alterations in the lead-myocardial interface (n = 12). Undersensing requiring revision occurred in 22 (58%) cases. Clinical sequelae of undersensing included failure to detect VT/VF (n = 4) and pacing-induced torsade de pointes (n = 1). Oversensing occurred in 12 (32%) and sequelae included inappropriate antitachycardia pacing ([ATP], n = 8), inappropriate ICD shock (n = 6), and ATP-induced VT (n = 1). CONCLUSION: The incidence of right ventricular lead dysfunction following LVAD implantation is significant and has important clinical sequelae. Physicians should remain vigilant for lead dysfunction after LVAD surgery and test lead function before discharge.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

June 2020

Volume

31

Issue

6

Start / End Page

1509 / 1518

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Prosthesis Implantation
  • Prosthesis Failure
  • Prosthesis Design
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Black-Maier, E., Lewis, R. K., Rehorn, M., Loungani, R., Friedman, D. J., Frazier-Mills, C., … Piccini, J. P. (2020). Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation. J Cardiovasc Electrophysiol, 31(6), 1509–1518. https://doi.org/10.1111/jce.14487
Black-Maier, Eric, Robert K. Lewis, Michael Rehorn, Rahul Loungani, Daniel J. Friedman, Camille Frazier-Mills, Kevin P. Jackson, et al. “Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation.J Cardiovasc Electrophysiol 31, no. 6 (June 2020): 1509–18. https://doi.org/10.1111/jce.14487.
Black-Maier E, Lewis RK, Rehorn M, Loungani R, Friedman DJ, Frazier-Mills C, et al. Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation. J Cardiovasc Electrophysiol. 2020 Jun;31(6):1509–18.
Black-Maier, Eric, et al. “Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation.J Cardiovasc Electrophysiol, vol. 31, no. 6, June 2020, pp. 1509–18. Pubmed, doi:10.1111/jce.14487.
Black-Maier E, Lewis RK, Rehorn M, Loungani R, Friedman DJ, Frazier-Mills C, Jackson KP, Atwater BD, Milano CA, Schroder JN, Pokorney SD, Piccini JP. Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation. J Cardiovasc Electrophysiol. 2020 Jun;31(6):1509–1518.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

June 2020

Volume

31

Issue

6

Start / End Page

1509 / 1518

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Prosthesis Implantation
  • Prosthesis Failure
  • Prosthesis Design