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Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club Evolving understanding of the heterogeneous natural history of individual coronary artery plaques and the role of local endothelial shear stress Relationship between fractional flow reserve value and the amount of subtended myocardium Bosentan therapy in patients with Eisenmenger syndrome: a multicenter, double-blind, randomized, placebo-controlled study Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial Optical coherence tomography and C-reactive protein in risk stratification of acute coronary syndromes

Expert Opinion2018 Apr 3;71(13):1483-1493.

JOURNAL:J Am Coll Cardiol. Article Link

Cardiac Implantable Electronic Devices in Patients With Left Ventricular Assist Systems

Berg DD, Vaduganathan M, Stewart GC et al. Keywords: advanced heart failure; implantable cardioverter-defibrillator; left ventricular assist system; mechanical circulatory support; permanent pacemaker

ABSTRACT


Recent progress and evolution in device engineering, surgical implantation practices, and periprocedural management have advanced the promise of durable support with left ventricular assist systems (LVAS) in patients with stage D heart failure. With greater uptake of LVAS globally, a growing population of LVAS recipients have pre-existing cardiac implantable electronic devices (CIEDs). Strategies for optimal clinical management of CIEDs in patients with durable LVAS are evolving, and clinicians will increasingly face complex decisions regarding implantation, programming, deactivation, and removal of CIEDs. Traditional decision-making pathways for CIEDs may not apply to LVAS-supported patients, as few patients die of arrhythmic causes and many arrhythmias may be well tolerated. Given limited data, treatment decisions must be individualized and made collaboratively among electrophysiologists, advanced heart failure specialists, and patients and their caregivers. Large, prospective, well-conducted studies are needed to better understand the contemporary utility of CIEDs in patients with newer-generation LVAS.