Effect of preoperative atrial fibrillation on patients with chronic heart failure who undergo long-term continuous-flow LVAD implantation

Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B. Civitello, Jeffrey A. Morgan

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Although preoperative atrial fibrillation (AF) is common in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation, how AF affects outcomes remains unclear. We analyzed our single-center experience with CF-LVAD implantation to determine whether preoperative AF was associated with inferior outcomes. From November 2003 through March 2016, 526 patients with chronic heart failure underwent implantation with the HeartMate II (HMII; n = 403) or HeartWare VAD (HVAD; n = 123). We identified 229 patients (165 HMII, 65 HVAD) who had preoperative AF and compared them with non–preoperative AF patients regarding the incidence of postoperative stroke, as well as long-term survival. After implantation, 139 patients had a stroke (78 non–preoperative AF patients [26.2%], 61 preoperative AF patients [26.6%]; p = 0.84). The rate of events per patient-year was 0.19 in non–preoperative AF patients and 0.22 in preoperative AF patients (p = 0.84). Survival was not significantly different between the two groups (p = 0.60). In Cox regression, preoperative AF was not associated with postoperative stroke (odds ratio: 1.13; 95% confidence interval [CI]: 0.74–1.74; p = 0.55) or survival (hazard ratio: 0.93; 95% CI: 0.71–1.25; p = 0.66). We conclude that in CF-LVAD recipients, preoperative AF did not diminish perioperative or long-term survival or increase the risk of postoperative stroke. These findings suggest that performing concomitant AF ablation during CF-LVAD implantation may be unnecessary.

Original languageEnglish (US)
Pages (from-to)594-600
Number of pages7
JournalASAIO Journal
Volume64
Issue number5
DOIs
StatePublished - Jan 1 2018

Keywords

  • Atrial fibrillation
  • Heart failure
  • Neurological dysfunction
  • Ventricular assist devices

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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