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Safety of six-month dual antiplatelet therapy after second-generation drug-eluting stent implantation: OPTIMA-C Randomised Clinical Trial and OCT Substudy 6-Month Versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent Implantation: The IVUS-XPL Randomized Clinical Trial Phenotypic Refinement of Heart Failure in a National Biobank Facilitates Genetic Discovery Cost-Effectiveness of Different Durations of Dual-Antiplatelet Use After Percutaneous Coronary Intervention Consensus from the 5th European Bifurcation Club meeting Intravascular ultrasound predictors for edge restenosis after newer generation drug-eluting stent implantation Effect of Luseogliflozin on Heart Failure With Preserved Ejection Fraction in Patients With Diabetes Mellitus Myofibroblast Phenotype and Reversibility of Fibrosis in Patients With End-Stage Heart Failure Titration of Medical Therapy for Heart Failure With Reduced Ejection Fraction SPECT and PET in ischemic heart failure

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.