CI-452769-3 INAPPROPRIATE ICD SHOCKS IN PATIENTS WITH LVADS: PREVALENCE, ASSOCIATED FACTORS, AND ETIOLOGIES

Left Ventricular Assist Devices (LVADs) are increasingly used to treat advanced heart failure. While most patients with an LVAD have implantable cardiac defibrillator (ICD) in situ, there limited data on the frequency and causes of ICD therapies LVADs. To define incidence, programming patient characteristics associated appropriate inappropriate shocks persons ICDs We performed a retrospective review at Duke University Hospital all recipients implanted HeartWare, HeartMate II, III (January 1, 2013 June 30, 2019) situ. were adjudicated by treating physician 2nd for purpose this study. Among 437 situ undergoing implant, 147 (33.6%) had least one shock episode following implantation. 12 excluded due incomplete device history. 135 patients, total 332 episodes: 257 (77.4%) n=75 (22.6%) inappropriate. Etiologies included SVT (n=66, 19.9%), physiologic oversensing (n=1, 0.3%), non-physiologic (n=8, 2.4%). Overall, 92 (68.1%) no episodes, 43 (31.8%) ≥ 1 14 (10.4%) 2 episodes. Moreover, 26 (19.3%) only shocks, 0 47 consistent consensus AHA recommendations (published after end follow-up). The rate is very high often supraventricular arrhythmias. Implementation current may help avoid shocks.