ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2022
Survival and adverse events in patients with atrial fibrillation at left ventricular assist device implantation: an analysis of the European Registry for Patients with Mechanical Circulatory Support.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Prognostic significance of atrial fibrillation resolution after left ventricular assist device implantation.JHLT open · 2026Article
- Atrial fibrillation in continuous flow-left ventricular assist device (CF-LVAD) patients: impact on pathophysiology.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- The impact of preoperative atrial fibrillation on survival and outcomes in heartmate II and heartmate 3 patients.BMC cardiovascular disorders · 2025Article
- The Long-Term Survival of LVAD Patients-A TriNetX Database Analysis.Journal of clinical medicine · 2024Article
- Catheter Ablation for Tachyarrhythmias in Left Ventricular Assist Device Recipients: Clinical Significance and Technical Tips.Journal of clinical medicine · 2023Review
- Left ventricular assist device-related infections and the risk of cerebrovascular accidents: a EUROMACS study.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2022Article
- Prediction, prevention, and management of right ventricular failure after left ventricular assist device implantation: A comprehensive review.Frontiers in cardiovascular medicine · 2022Review
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Abstract
objectivesAtrial fibrillation (AF) is a risk factor for mortality and cerebrovascular accidents (CVAs) and is common in patients with heart failure. This study evaluated survival and adverse events in patients with a left ventricular assist device (LVAD) and a history of AF in the European Registry for Patients with Mechanical Circulatory Support.
methodsPatients with a continuous-flow LVAD, AF or sinus rhythm (SR) and a follow-up were included. Kaplan-Meier analyses for survival (including a propensity-scored matched analysis), freedom from CVA, pump thrombosis, bleeding and a composite of pump thrombosis/CVA were performed. To correct for covariate imbalance, a Kaplan-Meier (KM) analysis was performed after propensity score (PS) matching the groups. Finally, a Cox regression was performed for predictors of lower survival.
resultsOverall, 1821 patients (83% male) were included, with a median age of 57 years and a median follow-up of 13.1 months (interquartile range: 4.3-27.7). Preoperative Electrocardiogram (ECG) rhythm was AF in 421 (23.1%) and SR in 1400 (76.9%) patients. Patients with pre-LVAD AF had a lower ≤90-day (81.9% vs 87.1%, P = 0.0047) and 4-year (35.4% vs 44.2%, P = 0.0083) survival compared to SR. KM analysis with PS matching groups revealed a trend (P = 0.087) towards decreased survival. Univariable analyses confirmed pre-LVAD AF as a predictor for mortality, but the multivariable analysis did not. No difference in the rate of adverse events was found. An analysis of patients at 24 months revealed a higher rate of CVAs for pre-LVAD AF patients (77% vs 94.3%, P < 0.0001).
conclusionsPatients with pre-LVAD AF undergoing LVAD implantation had a worse survival. However, after performing a multivariate analysis, and PS matching analysis, AF was no longer significant, indicating a worser preoperative condition in these patients. Concerning thrombo-embolic events, only patients with pre-LVAD AF alive beyond 24 months have a higher risk of CVAs.
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