Heart failure & cardiomyopathiesCohort study
Impact of implantable cardioverter-defibrillators on waitlist outcomes in children with ventricular assist devices
- propensity score matching
- Scientific Registry of Transplant Recipients data (2010-2024)
- cause-specific hazard models
Authors' conclusion
In a national cohort of pediatric VAD patients awaiting heart transplantation, there was no difference found in mortality, clinical deterioration, and rate of transplantation in patients with ICDs compared with those without.
Study context
- Population
- Pediatric VAD patients (aged <18 years) listed for primary heart-alone transplantpediatric VAD patients listed for heart transplant, 79 (6.3%) had implantable cardioverter-defibrillator (ICDs)
- Participants
- 1,263 patients
- Exposure
- pediatric VAD patients with and without ICDs
- ICDn = 79
Main finding
Waitlist mortality
Hazard ratio
1.1
95% CI 0.40–2.5
P = 0.76
ICD vs non-ICD
hazard ratio 1.1 (95% CI 0.40–2.5); P = 0.76
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Likelihood of transplant · matched | 1.2 (0.93–1.5) | P = 0.17 | |
| 0.512Hazard ratio (log scale) |
Baseline characteristics
- VAD type: left VAD
- 83%
- VAD type: bi-VAD
- 15%
- VAD type: right VAD
- 2.5%
- Age at listing, ICD vs non-ICD
- 15 vs 5 years; P < .0001
- Amiodarone use, ICD vs non-ICD
- 56% vs 13%; P = .0002
- Cardiac output, ICD vs non-ICD
- 3.9 vs 2.8 L/min; P = .0014
- Listed as United Network for Organ Sharing status 1A, ICD vs non-ICD
- 84% vs 92%; P = .015
- No significant differences in race, underlying diagnosis, VAD type, inotrope use, ventilator use, or extracorporeal membrane oxygenation use
Original publication
Impact of implantable cardioverter-defibrillators on waitlist outcomes in children with ventricular assist devices. Heart Rhythm. Published 24 June 2026. doi:10.1016/j.hrthm.2026.06.016
Summarised from the published abstract; every number is checked against it