Background
Outcomes of patients with implanted left ventricular assist device (LVAD) implantation
experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the
in-hospital outcomes of patients with implanted LVAD experiencing a CA.
Methods
The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients
older than 18 years with implanted LVAD and CA between 2010–2018. We excluded patients
with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation
and do not resuscitate (DNR) status.
Results
A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were
identified. Only 578 of these hospitalisations had experienced CA and of those, 173
(33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age
of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33
for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with
CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing
survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01),
and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease
and history of coronary artery bypass graft (CABG) were independently associated with
increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were
independently associated with in-hospital mortality. During the study period, there
was a significantly decreasing trend in performing CPR in LVAD hospitalisations with
CA.
Conclusion
In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and
CPR were independently associated with in-hospital mortality in LVAD hospitalisations
who experienced CA.
Keywords
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References
- Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes.Eur J Heart Fail. 2017; 19: 595-602
- Long-term use of a left ventricular assist device for end-stage heart failure.N Engl J Med. 2001; 345: 1435-1443
- Advanced heart failure treated with continuous-flow left ventricular assist device.N Engl J Med. 2009; 361: 2241-2251
- Sixth INTERMACS annual report: A 10,000-patient database.J Heart Lung Transplant. 2014; 33: 555-564
- Medical management of left ventricular assist device patients: a practical guide for the nonexpert clinician.Can J Cardiol. 2020; 36: 205-215
- Cardiopulmonary resuscitation in adults and children with mechanical circulatory support: a scientific statement from the American Heart Association.Circulation. 2017; 135: e1115-e1134
- Medical management of patients with a left ventricular assist device for the non-left ventricular assist device specialist.JACC Heart Fail. 2017; 5: 621-631
- Introduction to the HCUP Nationwide Inpatient Sample (NIS).2011
- Chest compressions may be safe in arresting patients with left ventricular assist devices (LVADs).Resuscitation. 2014; 85: 702-704
- In-hospital cardiopulmonary arrests in patients with left ventricular assist devices.J Card Fail. 2014; 20: 899-904
- Post-cardiac arrest mortality is declining: A study of the US national inpatient sample 2001 to 2009.Circulation. 2012; 126: 546-550
- Regional variation in the incidence and outcomes of in-hospital cardiac arrest in the United States.Circulation. 2015; 131: 1415-1425
- Causes of in-hospital cardiac arrest and influence on outcome.Resuscitation. 2012; 83: 1206-1211
- Predictors and clinical impact of late ventricular arrhythmias in patients with continuous-flow left ventricular assist devices.JACC Clin Electrophysiol. 2018; 4: 1166-1175
- Incidence, predictors, and clinical impact of electrical storm in patients with left ventricular assist devices: New insights from the ASSIST-ICD study.Heart Rhythm. 2019; 16: 1506-1512
- Management of ventricular arrhythmias in patients with LVAD.Curr Opin Cardiol. 2020; 35: 289-294
- Epidemiologic study of in-hospital cardiopulmonary resuscitation in the elderly.N Engl J Med. 2009; 361: 22-31
- Epidemiology and outcomes of in-hospital cardiopulmonary resuscitation in the United States, 2000-2009.Resuscitation. 2013; 84: 1255-1260
- Cardiopulmonary resuscitation of a cardiac arrest patient with left ventricular assist device in an out-of-hospital setting: A case report.Medicine (United States). 2020; 99: e18658
- Left ventricular assist device management in the ICU.Crit Care Med. 2014; 42: 158-168
- Do sex differences exist in the establishment of “do not attempt resuscitation” orders and survival in patients successfully resuscitated from in-hospital cardiac arrest?.J Am Heart Assoc. 2020; 9: e014200
- Effect of gender on outcome of out of hospital cardiac arrest in the Resuscitation Outcomes Consortium.Resuscitation. 2016; 100: 76-81
Article info
Publication history
Published online: July 02, 2021
Accepted:
May 10,
2021
Received in revised form:
May 6,
2021
Received:
December 1,
2020
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
