Left Ventricular Assist Device Implantation in the Presence of Substernal Extravascular Implantable Cardioverter-Defibrillator.

Extravascular implantable cardioverter-defibrillator is a recently developed substernal system to prevent sudden cardiac death. Extravascular devices, such as subcutaneous and substernal implantable cardioverter-defibrillators, were designed to avoid the possible complications of conventional transvenous leads. However, their combination with a left ventricular assist device (LVAD) is often challenging. Electromagnetic interference generated by the LVAD may affect previously implanted cardioverter-defibrillators, particularly subcutaneous extravascular devices. To our knowledge, this is the first reported experience of the concomitant use of an extravascular implantable cardioverter-defibrillator with a durable LVAD.