Suzuki Atsushi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Impact of Recurrent Ventricular Tachyarrhythmia on Outcome in Japanese Heart Transplant Candidates With a Left Ventricular Assist Device.
Journal Formal name:Circulation journal : official journal of the Japanese Circulation Society
Abbreviation:Circ J
ISSN code:1346-9843/1347-4820
Domestic / ForeginDomestic
Publisher The Japanese Circulation Society
Volume, Issue, Page 82(9),2305-2310頁
Author and coauthor HATTORI Hidetoshi†, SUZUKI Atsushi, SHIGA Tsuyoshi*, NISHINAKA Tomohiro, SAITO Satoshi, YAMAZAKI Kenji, NUNODA Shinichi, HAGIWARA Nobuhisa
Publication date 2018/08
Summary BACKGROUND:
Recurrent ventricular tachyarrhythmias (VTA) are "A factor" modifiers in the Interagency Registry for Mechanically Assisted Circulatory Support profile. The effect of recurrent VTA on clinical outcome, however, is controversial. We evaluated the impact of recurrent VTA on outcome in Japanese heart transplant candidates with a left ventricular assist device (LVAD). Methods and Results: Sixty-six adult patients with advanced heart failure who were listed for heart transplantation between January 2005 and October 2017 were enrolled in the study. Recurrent VTA (modifier A status) was defined as a sustained ventricular tachycardia or fibrillation that required implantable cardioverter defibrillator shocks or an external defibrillator more than twice weekly. The primary outcome was death from any cause. The secondary outcomes were the first occurrence of VTA and recurrent VTA after LVAD implantation. Sixteen patients (24%) met the criteria for modifier A status, and 15 patients had an LVAD implanted. During a median follow-up of 1,124 days, 21 of 60 patients with an LVAD died. There was a significantly higher mortality rate in LVAD patients with modifier A status than in those who did not meet the modifier A criteria. On multivariate analysis, patients with modifier A status had an increased risk of mortality (HR, 3.43; 95% CI: 1.30-8.61, P=0.001).

CONCLUSIONS:
Recurrent VTA might be a marker for worse outcome in Japanese heart transplant candidates with an LVAD.
DOI 10.1253/circj.CJ-18-0294
PMID 30012930