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Background: The LVAD is a mechanical pump that takes blood from the left lower chamber of the heart and pumps it via the aorta to the body and vital organs, supporting heart function and blood flow. LVADs are indicated for individuals with significant heart disease recovering after heart surgery, waiting for a heart transplant, or whom are ineligible for a heart transplant.
On EKG, patients with ventricular heart disease show broad QRS durations. We examined changes to the QRS duration in patients who underwent LVAD implantation.
Methods: We conducted a retrospective chart review of 144 patients with ventricular heart disease who underwent LVAD implantation. ECG results were reviewed prior to LVAD implantation when available, and after LVAD implantation at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, when available. 140 ECGs were reviewed pre-implant, and 29 patients were excluded due to variable conduction throughout patient chart history (paced vs. intrinsic heart rhythm). A total of 113 patients were analyzed (paired t-test).
Results: After LVAD implantation, overall there was a significant reduction in QRS width at all time points recorded up to 1 year. Patients with native rhythm had a significant reduction in QRS width to 85.9 ± 14.9 ms P<0.001) at 1 week, 92.6 ± 19.7 (P=0.006) at 1 month, and 77.3 ± 23.4 (P=0.032) at 2 years. For patients with a paced rhythm a significant reduction in QRS duration was seen to be 142.2 ± 21.8 (P<0.001) at 1 week, 138.4± 24.1 (P<0.005) at 6 months, and 132.5 ± 25.1 (P=0.022) at 1 year. The fluctuation in the significance of the reduction was due to a low count (<20 cases per group). There was inconsistent correlation of QRS width with left ventricular size (r=0.39, 0.61, and 0.77 at baseline, 3 months, and 6 months, with P=0.001, 0.06 and 0.02 respectively).
Conclusions: There is consistent reduction seen in QRS duration after LVAD implantation. The effect is seen at 1 week after initial implant and persisted for 2 years of follow-up. The significance in reduction is observed in both native and extrinsically paced QRS patient group data. The alteration in QRS duration may represent the effects of LVAD unloading of the left ventricle, by consequent functioning of the device.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Intervention in Interventional Cardiology: Advanced Device Use
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1155-152
- 2017 American College of Cardiology Foundation