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Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review.

Publication ,  Journal Article
Black-Maier, E; Lewis, RK; Barnett, AS; Pokorney, SD; Sun, AY; Koontz, JI; Daubert, JP; Piccini, JP
Published in: Heart Rhythm
September 2020

BACKGROUND: There are limited data on the performance of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in patients with a left ventricular assist device (LVAD). OBJECTIVE: The purpose of this study was to describe the clinical course and outcomes of patients with both an S-ICD and an LVAD at our institution and via a systematic review of published studies. METHODS: We performed a retrospective cohort study of all patients who underwent LVAD implantation from 2009 to 2019 at Duke University Hospital. We also performed a systematic review of studies involving patients with an S-ICD and LVAD using the PubMed/Embase databases. RESULTS: Of 588 patients undergoing LVAD implantation with a preexisting implantable cardioverter-defibrillator, 4 had an S-ICD in situ after LVAD implantation. All 4 patients developed electromagnetic interference (EMI) in the primary/secondary vectors after LVAD implantation, resulting in inappropriate implantable cardioverter-defibrillator shocks in 2 patients. Sensing in the alternate vector was adequate immediately postoperatively in 1 patient. Postoperative undersensing was present in the alternate vector in 3 patients but improved at first outpatient follow-up in 2 patients, allowing tachy therapies to be reenabled. Eight studies involving 27 patients were identified in the systematic review. EMI was common and frequently absent in the alternate vector (6 of 7 patients). CONCLUSION: Undersensing and EMI are common after LVAD implantation in patients with an S-ICD in situ, particularly in the primary and secondary sensing vectors. Undersensing in the alternate vector may improve during follow-up, obviating the need for device revision or extraction.

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Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

September 2020

Volume

17

Issue

9

Start / End Page

1536 / 1544

Location

United States

Related Subject Headings

  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Equipment Failure Analysis
  • Defibrillators, Implantable
  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 0903 Biomedical Engineering
 

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Black-Maier, E., Lewis, R. K., Barnett, A. S., Pokorney, S. D., Sun, A. Y., Koontz, J. I., … Piccini, J. P. (2020). Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review. Heart Rhythm, 17(9), 1536–1544. https://doi.org/10.1016/j.hrthm.2020.04.019
Black-Maier, Eric, Robert K. Lewis, Adam S. Barnett, Sean D. Pokorney, Albert Y. Sun, Jason I. Koontz, James P. Daubert, and Jonathan P. Piccini. “Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review.Heart Rhythm 17, no. 9 (September 2020): 1536–44. https://doi.org/10.1016/j.hrthm.2020.04.019.
Black-Maier E, Lewis RK, Barnett AS, Pokorney SD, Sun AY, Koontz JI, et al. Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review. Heart Rhythm. 2020 Sep;17(9):1536–44.
Black-Maier, Eric, et al. “Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review.Heart Rhythm, vol. 17, no. 9, Sept. 2020, pp. 1536–44. Pubmed, doi:10.1016/j.hrthm.2020.04.019.
Black-Maier E, Lewis RK, Barnett AS, Pokorney SD, Sun AY, Koontz JI, Daubert JP, Piccini JP. Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review. Heart Rhythm. 2020 Sep;17(9):1536–1544.
Journal cover image

Published In

Heart Rhythm

DOI

EISSN

1556-3871

Publication Date

September 2020

Volume

17

Issue

9

Start / End Page

1536 / 1544

Location

United States

Related Subject Headings

  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Equipment Failure Analysis
  • Defibrillators, Implantable
  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
  • 0903 Biomedical Engineering