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      Electromagnetic Interference from Left Ventricular Assist Device (LVAD) Inhibiting the Pacing Function of an Implantable Cardioverter-Defibrillator (ICD) Device

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          Abstract

          There is an increasing prevalence of patients with concomitant implantable cardioverter-defibrillators (ICDs) and left ventricular devices (LVADs). The potential for negative interactions between these continually evolving technologies is a valid concern. Previously reported interactions include inappropriate ICD therapy and interference with ICD telemetry function. Understanding the nature of such interactions and developing a comprehensive strategy to approach such situations are important. In this report, we describe a case of electromagnetic interference from LVAD inhibiting the pacing function of an ICD that was corrected by reprograming the device. We would encourage investigators to review patients with ICD and LVAD in their institutions in order to help assess the frequency and nature of these and other interactions.

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          Most cited references7

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          Adverse interaction between a left ventricular assist device and an implantable cardioverter defibrillator.

          An increasing number of patients have a coexisting implantable cardioverter defibrillator (ICD) and left ventricular assist device (LVAD) to treat ventricular arrhythmias and refractory heart failure, respectively. To date, there have been no published reports of negative interactions between these devices that have impacted appropriate ICD or LVAD function. In this case report, we describe a patient with an LVAD-ICD interaction that necessitated replacement of the implantable defibrillator.
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            Left ventricular mechanical assist devices and cardiac device interactions: an observational case series.

            Nonpulsatile left ventricular assist devices (LVADs) are increasingly used for treatment of refractory heart failure. A majority of such patients have implanted cardiac devices, namely implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy-pacemaker (CRT-P) or cardiac resynchronization therapy-defibrillator (CRT-D) devices. However, potential interactions between LVADs and cardiac devices in this category of patients remain unknown.
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              Implantable defibrillator with left ventricular assist device compatibility.

              Implanted defibrillator (ICD) and HeartMate-II (Thoratec, Pleasanton, CA, USA) left ventricular assist device (LVAD) incompatibilities have been reported. In order to show which ICD would function regularly in Heart Mate II recipients, we conducted a systematic review of 39 consecutive patients with implanted ICD and HeartMate-II from our institution's LVAD registry. Forty-six ICDs were identified without device interactions in most ICD devices. However, loss of ICD to programmer telemetry was observed in four patients with V-193, V-196 and V-350 (St Jude Medical, Sunnyvale, CA, USA) and one patient with an Ovatio DR (Sorin, Milan, Italy) requiring ICD replacement. The majority of all investigated ICDs operated without LVAD to ICD interaction. However, surgeons implanting the Heart Mate II in ICD patients should be aware of possible interactions and incompatible devices should not be recommended in HeartMate-II recipients.
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                Author and article information

                Contributors
                Journal
                Case Rep Cardiol
                Case Rep Cardiol
                CRIC
                Case Reports in Cardiology
                Hindawi
                2090-6404
                2090-6412
                2018
                3 October 2018
                : 2018
                : 6195045
                Affiliations
                1Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
                2Department of Medicine, Providence VA Medical Center, Providence, RI, USA
                3Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
                Author notes

                Academic Editor: Nurten Sayar

                Author information
                http://orcid.org/0000-0001-6763-3804
                Article
                10.1155/2018/6195045
                6192132
                fd93def0-9274-4c3f-acc8-ccae87cea600
                Copyright © 2018 Sebhat Erqou et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 July 2018
                : 6 September 2018
                Categories
                Case Report

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