Trend and Outcomes of Cardiac Dysrhythmias in Lvad Recipients

Abstract

Background Cardiac dysrhythmias are a common cause of hospitalization in patients with left ventricular assist device (LVAD). There is limited data on the incidence of VT over time and associated mortality in patients with LVAD. We aimed to identify the incidence of VT post LVAD implant and associated in hospital mortality. Methods Subjects with history of LVAD who had cardiac dysrhythmias as a primary diagnosis were identified from the National Inpatient Sample (NIS) dataset of the Healthcare Cost and Utilization Project (HCUP) for the years 2005-2017 using ICD-9 and10 codes. We also identified the in-hospital outcomes of VT. We excluded patients with history of orthotropic heart transplant and history of biventricular assist device (BiVAD). Associated morbidities and in-hospital outcomes were evaluated. Results A total of 15131 LAVD hospitalizations were identified and 703 patients hospitalized with a primary diagnosis of cardiac dysrhythmias. The median age of patients was 60 years (IQR 51-67), and 57.8% were White. VT was the primary cause of hospitalization in 542 patients (77.5%), followed by atrial fibrillation and flutter, 126(17.9%), then paroxysmal supraventricular tachycardia, 24(3.4%) . Among patients who had VT, 62 patients (11.4%) had cardiac arrest, 2 (0.4%) needed CPR, 17(3.1%) had cardiogenic shock, 4(0.7%) had acute myocardial infarction, 4(0.7%) had acute stroke, 2(0.4%) had brain death, 13 (2.4%) needed mechanical ventilation, 42 (7.7%) had ICD implanted. There was no significant increase in incidence of hospitalization for VT in LVAD patients over the study period.(Std. J-T Statistic 1.371, p = 0.170). Figure 1. The overall in hospital death in these patients was 13(1.8%). Conclusion In LVAD patient VT was found to be most common arrhythmia causing hospitalization but overall mortality was low.