Heart failure & cardiomyopathies
Appropriate and inappropriate implantable cardioverter-defibrillator (ICD) shocks in patients with left ventricular assist device (LVADs): Prevalence, associated factors, and etiologies
Authors' conclusion
The rate of inappropriate shocks in LVAD recipients is very high and most often is due to supraventricular arrhythmias. LVAD electromagnetic interference is a rare cause of ICD shock.
Study context
- Population
- LVAD recipients with a preexisting ICD, Duke University Hospital, January 2013–June 2019134 with complete device history
- Participants
- 421 recipients
- Outcome
- Incidence of appropriate and inappropriate ICD shocks after LVAD implantation
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
ICD shocks after LVAD implantation
Patients with ≥1 shock after LVAD implantation
147
33.9%
Total shock episodes (134 patients with complete device history)
330
Appropriate shocks
255
77.3%
Inappropriate shocks
75
22.7%
Observational data: associations, not effects.
Further findings
Etiologies of inappropriate shocks
- Supraventricular tachycardia
- n = 66 [20.0%]
- Physiological oversensing
- n = 1 [0.3%]
- Nonphysiological oversensing
- n = 8 [2.4%]
- LVAD electromagnetic interference (within nonphysiological oversensing)
- n = 1 [0.3%]
ICD programming in high-rate zones, inappropriate vs appropriate shock
- Shorter detection delay more common in inappropriate shock
- P < 0.001
- Absence of antitachycardia pacing programming more common in inappropriate shock
- P = 0.001
Original publication
Appropriate and inappropriate ICD shocks in patients with LVADs: Prevalence, associated factors, and etiologies. Heart Rhythm. Published 23 July 2024. doi:10.
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