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Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions Sex Differences in Heart Failure With Preserved Ejection Fraction Pathophysiology: A Detailed Invasive Hemodynamic and Echocardiographic Analysis Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions Initial Invasive or Conservative Strategy for Stable Coronary Disease Novel predictor of target vessel revascularization after coronary stent implantation: Intraluminal intensity of blood speckle on intravascular ultrasound Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies IVUS in bifurcation stenting: what have we learned? 6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel)
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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.

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