Electrocardiographic changes after implantation of a left ventricular assist device - Potential implications for subcutaneous defibrillator therapy.
J Electrocardiol
; 52: 29-34, 2019.
Article
in En
| MEDLINE
| ID: mdl-30476635
ABSTRACT
BACKGROUND:
Implantation of a left ventricular assist device (LVAD) leads to a diverse spectrum of changes on the twelve-lead surface electrocardiogram (ECG). We aimed to elucidate the changes of the surface ECG in patients after LVAD implantation potentially impacting ECG based screening tests of subcutaneous implantable cardioverter-defibrillators (S-ICD).METHODS:
Patients from 2005 until 2017 with a documented twelve-lead ECG before and after LVAD implantation were included. Baseline parameters were obtained through hospital records. The twelve-lead ECGs registered before and after LVAD implantation were analyzed.RESULTS:
From 415 patients undergoing an LVAD implantation, complete datasets were available for 253 patients. 216 patients (85%) were male. Mean age at time of LVAD implantation was 54.7⯱â¯12.4â¯years. The underlying etiology was ischemic cardiomyopathy in 119 (47%), dilated cardiomyopathy in 112 (44%), myocarditis in 8 (3%) and other in 14 (6%). We observed a reduction in the amplitude of the R wave in lead I (pâ¯<â¯0.0001), lead II (pâ¯<â¯0.0001), lead III (pâ¯<â¯0.004), lead aVL (pâ¯<â¯0.001) and lead aVF (pâ¯<â¯0.0001) as well as of the S wave in lead III (pâ¯<â¯0.001) and lead aVR (pâ¯<â¯0.0001) after LVAD implantation. We also noticed a reduction of the RT ratio in lead I (pâ¯<â¯0.0001) as well as in lead II (pâ¯=â¯0.100) and lead aVF (pâ¯=â¯0.292) although statistically non-significant.CONCLUSION:
LVAD implantation leads to significant alterations of the surface ECG, especially the RT ratio in leads I, II and aVF. These leads correlate with the vectors of the ECG based S-ICD screening test. Thus, these ECG changes may impact the continuous eligibility for subcutaneous ICD therapy in patients after LVAD implantation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart-Assist Devices
/
Electrocardiography
/
Cardiomyopathies
/
Myocarditis
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Electrocardiol
Year:
2019
Document type:
Article
Affiliation country: