The association of obstructive sleep apnea and complications in patients following implantation of left ventricular assist devices.

INTRODUCTION

Left ventricular assist devices (LVAD) are utilized for stage D Heart Failure (HF) patients refractory to medical and device therapies. Obstructive sleep apnea (OSA) is prevalent in nearly half of HF patients, however few studies exist on the relationship of OSA and outcomes in patients following LVAD implantation. This study aims to enhance the understanding of the interplay between HF, OSA, and complications post-LVAD implantation.

METHODS

Utilizing the 2020 National Inpatient Sample (NIS) database, a retrospective observational study assessed 22,450 adult patient hospitalizations following LVAD implantation procedure, with 1,964 of those patients having a concomitant diagnosis of OSA.

RESULTS

Among 22,450 adult patients hospitalized following LVAD procedure in 2020, approximately 9% had concomitant OSA. While OSA patients did not have significantly different inpatient mortality, length of stay, or hospital charges compared to non-OSA patients, they had a significantly higher prevalence of atrial fibrillation (37% vs. 26%, p < 0.001). There were no differences in the rates of pulmonary embolism and cerebrovascular accident, and the need for blood transfusion.

CONCLUSIONS

OSA is a common comorbidity among patients following LVAD implantation procedures. Our data suggest no relationship between OSA and overall post-operative mortality. The higher prevalence of atrial fibrillation in patients with OSA highlights the need for careful preoperative rhythm assessment and continued monitoring of arrhythmias in this subset of patients. These results add guidance to the shared decision-making with patients being considered for this therapy.