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

2 Citations (Scopus)

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
Externally publishedYes

Fingerprint

Left ventricular assist devices
Atrial Fibrillation
Heart Failure
Heart-Assist Devices
Ablation
Stroke
Hazards
Survival
Confidence Intervals

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 journalArticle

Kurihara, Chitaru ; Critsinelis, Andre ; Kawabori, Masashi ; Sugiura, Tadahisa ; Civitello, Andrew B. ; Morgan, Jeffrey A. / Effect of preoperative atrial fibrillation on patients with chronic heart failure who undergo long-term continuous-flow LVAD implantation. In: ASAIO Journal. 2018 ; Vol. 64, No. 5. pp. 594-600.
@article{ed6a8ea3e3f74ef6aaed789a08a1abb4,
title = "Effect of preoperative atrial fibrillation on patients with chronic heart failure who undergo long-term continuous-flow LVAD implantation",
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.",
keywords = "Atrial fibrillation, Heart failure, Neurological dysfunction, Ventricular assist devices",
author = "Chitaru Kurihara and Andre Critsinelis and Masashi Kawabori and Tadahisa Sugiura and Civitello, {Andrew B.} and Morgan, {Jeffrey A.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/MAT.0000000000000762",
language = "English (US)",
volume = "64",
pages = "594--600",
journal = "ASAIO journal (American Society for Artificial Internal Organs : 1992)",
issn = "1058-2916",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

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 -