Atrial Tachyarrhythmias Among Patients With Left Ventricular Assist Devices

Noll, Andrew; Adewumi, Joseph; Amuthan, Ram; Gillombardo, Carl B.; Mannan, Zariyat; Kiehl, Erich L.; Hussein, Ayman A.; Chung, Mina K.; Wazni, Oussama; Starling, Randall C.; Soltesz, Edward G.; Cantillon, Daniel J.

doi:10.1016/j.jacep.2018.11.016

Cited by 16 publications

(14 citation statements)

References 16 publications

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“…Consistent with the findings of Enriquez et al (10), we found that the signal of increased mortality was observed in patients with persistent AF, and not paroxysmal AF or AFL. The present results do not necessarily contradict these findings because the current analysis by Noll et al (7) and Hickey et al (8) did not categorize outcomes by AF type. Furthermore, the investigators grouped AFL into the present analysis, so it remains unknown whether differential outcomes by AA sub-type were present.…”

contrasting

confidence: 68%

“…Would CASTLE-AF (Catheter Ablation vs. Standard Conventional Treatment in Patients With LV Dysfunction and AF) (5) or AFFIRM Fibrillation Follow-up Investigation of Rhythm Management) (6) in LVAD patients show any clinical benefit? In this context, Noll et al (7) in this issue of JACC: Clinical Electrophysiology present a retrospective analysis of 418 patients over a 12-year period at the Cleveland Clinic to examine the impact of AF/atrial flutter (AFL) on long-term survival, thromboembolism, and major bleeding in LVAD recipients. Importantly, they sought to assess the impact of rhythm control in this cohort by assessing outcomes in those that had exposure to an antiarrhythmic medication through chart review.…”

mentioning

confidence: 99%

“…Interestingly, Noll et al (7) report that patients with AF/AFL had significantly lower rates of thromboembolism (13% vs. 23%) driven by ischemic stroke, which is biologically implausible. Enriquez et al (10), Stulak et al (9), and our group (11) reported consistent findings of higher rates of thromboembolic event(s)s in patients with AF.…”

mentioning

confidence: 99%

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Atrial Arrhythmias in Patients With Left Ventricular Assist Devices

Tung

Özcan

2019

JACC: Clinical Electrophysiology

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contrasting

confidence: 68%

mentioning

confidence: 99%

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Atrial Arrhythmias in Patients With Left Ventricular Assist Devices

Tung

Özcan

2019

JACC: Clinical Electrophysiology

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“…Another case report showed the same result after segmental pulmonary vein isolation in poorly controlled AF [66, 67]. According to Noll et al [46] in a retrospective analysis of 418 patients over 12 years, rhythm control by ablation, maze or drugs is not associated with clinical outcome in terms of mortality, thromboembolism or bleeding. When warfarin is administered previously to implantation, the improvement of hepatic perfusion by the device can increase synthesis of vitamin K-dependent clotting factors and alter the pharmacodynamic response to this drug [68].…”

Section: Therapeutic Perspectives For Af In Lvad Patientsmentioning

confidence: 90%

“…More than 40% of patients with a previous history of AF will never have a recurrence in the long-term follow-up after implantation [45]. For this reason, according to some authors, development of AF episodes after implantation may be an indirect index of inadequate mechanical support, and, consequently, AF burden together with LA volume could be noninvasive parameters for the chronic optimization of LVADs [46]. Decrease in mitral regurgitation after implantation leads to reduced atrial flow velocities and increased probability of thrombus formation [47-49].…”

Section: Hemodynamics Effects Of Af In Lvad Patientsmentioning

confidence: 99%

Insight into Atrial Fibrillation in LVAD Patients: From Clinical Implications to Prognosis

Sisti¹,

Mandoli²,

Sciaccaluga³

et al. 2020

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The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables in the management of such patients but the main attention has always been focused on ventricular arrhythmias given the detrimental impact on mortality. Nevertheless, atrial fibrillation (AF) is the most common rhythm disorder associated with advanced heart failure and may therefore characterize the LVADs' pre-and postimplantation periods. Indeed, the consequences of AF in the population suffering from standard heart failure may require a more comprehensive evaluation in the presence of or in sight of an LVAD, making the AF clinical management in these patients potentially complex. Several studies have been based on this subject with different and often conflicting results, leaving many questions unresolved. The purpose of this review is to summarize the main pieces of evidence about the clinical impact of AF in LVAD patients, underlining the main implications in terms of hemodynamics, thromboembolic risk, bleeding and prognosis. Therapeutic considerations about the clinical management of these patients are also made according to the latest evidence.

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HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non‐hospital settings in the community

et al. 2021

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The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general

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Atrial Tachyarrhythmias Among Patients With Left Ventricular Assist Devices

Cited by 16 publications

References 16 publications

Atrial Arrhythmias in Patients With Left Ventricular Assist Devices

Atrial Arrhythmias in Patients With Left Ventricular Assist Devices

Insight into Atrial Fibrillation in LVAD Patients: From Clinical Implications to Prognosis

HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non‐hospital settings in the community

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