HF-567-04 VENTRICULAR TACHYCARDIA PRIOR TO CFLVAD IMPLANTATION DOES NOT IMPACT SURVIVAL WHEN STRATIFIED BY VAD TYPE

Abstract

Historically, the occurrence of ventricular tachycardia (VT) prior to implantation of continuous flow left ventricular assist device (CFLVAD) has been associated with worse long term survival. In the era of more modern CFLVADs, pre-implant VT may no longer significantly impact survival. To evaluate one-year transplant free survival by modern CFLVAD types based on the occurrence of pre-implant sustained VT. We retrospectively studied all patients who underwent both destination therapy and bridge to transplant initial CFLVAD implantation at our institution from 2017-2019. Patients who received a simultaneous RVAD or orthotropic heart transplant within one year after CFLVAD were excluded. We ascertained the occurrence of sustained VT in the year prior to implantation based on clinical documentation and available implantable cardioverter-defibrillator interrogation reports. Using independent sample t-tests with significance set to p<0.05, one-year transplant free survival was compared in those with and without pre-implant VT for CFLVADs including the Abbott Heartmate 3 (HM3), Abbott Heartmate 2 (HM2), and HeartWare HVAD (HW). There were 103 initial CFLVAD implants between 2017-2019, 38 HM3, 37 HM2, and 28 HW. Within the HM3 group, one-year TFS was 69% in those with pre-implant VT and 88% in those without pre-implant VT, p=0.1654. Within the HM2 group, one-year TFS was 68% in those with pre-implant VT and 61% in those without pre-implant VT, p=0.6526. Within the HW group, one-year TFS was 80% in those with pre-implant VT and 72% in those without pre-implant VT, p=0.6632. For all CFLVADs, one-year TFS was 71% in those with pre-implant VT and 75% in those without pre-implant VT, p=0.6555. Contrary to prior reports, sustained VT in the year prior to CFLVAD implantation did not reduce one-year transplant free survival in this cohort regardless of the type of CFLVAD implanted. In the modern era of CFLVAD implantation, pre-implant sustained VT may not necessarily be a contraindication. Further studies assessing sustained VT in the CFLVAD population are warranted.