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 language | English (US) |
|---|---|
| Pages (from-to) | 594-600 |
| Number of pages | 7 |
| Journal | ASAIO Journal |
| Volume | 64 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 2018 |
| Externally published | Yes |
Fingerprint
Keywords
- Atrial fibrillation
- Heart failure
- Neurological dysfunction
- Ventricular assist devices
ASJC Scopus subject areas
- Biophysics
- Bioengineering
- Biomaterials
- Biomedical Engineering
Cite this
Effect of preoperative atrial fibrillation on patients with chronic heart failure who undergo long-term continuous-flow LVAD implantation. / Kurihara, Chitaru; Critsinelis, Andre; Kawabori, Masashi; Sugiura, Tadahisa; Civitello, Andrew B.; Morgan, Jeffrey A.
In: ASAIO Journal, Vol. 64, No. 5, 01.01.2018, p. 594-600.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of preoperative atrial fibrillation on patients with chronic heart failure who undergo long-term continuous-flow LVAD implantation
AU - Kurihara, Chitaru
AU - Critsinelis, Andre
AU - Kawabori, Masashi
AU - Sugiura, Tadahisa
AU - Civitello, Andrew B.
AU - Morgan, Jeffrey A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Heart failure
KW - Neurological dysfunction
KW - Ventricular assist devices
UR - http://www.scopus.com/inward/record.url?scp=85056470334&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056470334&partnerID=8YFLogxK
U2 - 10.1097/MAT.0000000000000762
DO - 10.1097/MAT.0000000000000762
M3 - Article
C2 - 29485425
AN - SCOPUS:85056470334
VL - 64
SP - 594
EP - 600
JO - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JF - ASAIO journal (American Society for Artificial Internal Organs : 1992)
SN - 1058-2916
IS - 5
ER -