Comparison of the burden of ventricular arrhythmias before and after left ventricular assist device implantation: A retrospective observational study.

Ventricular arrhythmias (VAs) are frequently observed in patients awaiting or who have already undergone left ventricular assist device (LVAD) implantation. However, the impact of LVAD implantation on the burden of VAs and the prognostic significance of postoperative VAs remain unclear. Between June 2015 and July 2024, 108 patients who underwent LVAD implantation were retrospectively analyzed. The burden of VAs was defined as the total number of documented VAs or implantable cardioverter-defibrillator therapies, including anti-tachycardia pacing and appropriate shocks. The incidence and burden of VAs before and after LVAD implantation were compared, and factors associated with postoperative VAs were evaluated using multivariable regression analysis. Among the 108 patients who successfully underwent LVAD implantation, the prevalence of VAs decreased after implantation (39.8% [n = 43] vs 25.9% [n = 28], P < .01). However, there was no significant difference in the burden of VAs before and after LVAD implantation (4.30 ± 31.42 vs 2.89 ± 13.11 events/mo, P = .50). The incidence of VAs, anti-tachycardia pacing, and appropriate shocks did not significantly decrease after LVAD implantation (2.34 ± 16.89 vs 2.26 ± 13.04, P = .26; 1.22 ± 7.68 vs 0.91 ± 5.82, P = .58; and 0.88 ± 7.24 vs 0.28 ± 1.29, P = .21, respectively). Multivariable regression analysis showed that only preoperative VAs were associated with postoperative VAs (hazard ratio 15.6 [95% confidence interval, 3.70-64.49]; P < .01). There was no significant difference in survival according to the occurrence of postoperative VAs (P = .94). LVAD implantation does not reduce the burden of VAs. A history of preoperative VAs remains a strong risk factor for postoperative VAs. However, even if VAs occurred after LVAD implantation, the mortality risk did not increase.