Survival after left ventricular assist device implantation correlates with a novel device-based measure of heart rate variability: the heart rate score.

Abstract

OBJECTIVES\nThe heart rate score (HRS) serves as a device-based measure of impaired heart rate variability and is an independent predictor of death in patients with heart failure and a cardiac implantable electrical device. However, no data are available for predicting death from the HRS in patients with end stage heart failure and a left ventricular assist device.\n\n\nMETHODS\nFrom November 2011 to July 2018, a total of 56 patients with a pre-existing cardiac implantable electrical device underwent left ventricular assist device implantation at our 2 study sites. The ventricular HRS was calculated retrospectively during the first cardiac implantable electrical device follow-up examination following the index hospitalization. Survival during follow-up was correlated with initial HRS.\n\n\nRESULTS\nDuring the follow-up period, 46.4% of the patients (n\u2009=\u200926) died. The median follow-up period was 33.2\u2009months. The median HRS after the index hospitalization was 41.1\u2009±\u200921.8%. More patients with an HRS >65% died compared to patients with an HRS <30% (76.9% vs 14.4%; P\u2009=\u20090.007).\n\n\nCONCLUSIONS\nIn our multicentre experience, survival of patients after an left ventricular assist device implant correlates with the HRS. After confirmation of our findings in a larger cohort, the effect of rate-responsive pacing will be within the scope of further investigation.