ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Implantable Cardioverter-Defibrillator Use in Patients with Left Ventricular Assist Device: Prediction of Ventricular Arrhythmia Using the VT-LVAD Score
Emmanuelle Massie 1,2
Jacinthe Boulet 1,3
Corrado De Marco 1,3
Pierre-Emmanuel Noly 4,5
Yoan Lamarche 2
Blandine Mondesert 1
Anique Ducharme 1,3
1. Department of Medicine, Montreal Heart Institute, Montreal, Canada
2. Institut De Cardiologie de Montreal, Montreal, Canada
3. Universite de Montreal, Montreal, Canada
4. Universite de Montreal Institut de Cardiologie de Montreal, Montreal, Canada
5. Department of surgery, Montreal, Canada
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Abstract
ABSTRACT Background: The survival benefit of implantable cardioverter-defibrillators (ICD) in patients with left ventricular assist device (LVAD) remains unproven. The VT-LVAD score was developed to stratify arrhythmic risk and may help identify patients most likely to benefit from ICD therapy. We aimed to retrospectively assess its ability to identify patients at higher risk of ventricular arrythmias and to describe ICD-related complications in a population of patients with ICD and LVAD. Methods: A total of 63 primary continuous-flow LVAD implantation were performed at our institution between January 2010 and March 2020 were included and stratified by risk (VT-LVAD score <5 or 5). Thirty patients (47.6%) had a low/intermediate risk VT-LVAD score (<5) (Group 1) and 33 (52.4%) a high/very high-risk VT-LVAD (score 5) Group 2). Patients either had a previous ICD or were implanted before discharge, unless transplanted urgently. Early postoperative outcomes, including in-hospital arrhythmic events with hemodynamic instability, were collected, along with long-term outcomes such as all-cause mortality, ICD therapies, and ICD-related complications. Results: Patients with a VT-LVAD score 5 were more likely to experience in-hospital ventricular arrhythmias (VAs) than those with score <5 (91% vs. 43%, p<0.001). These VAs occurred mainly in the first five postoperative days, often due to an underlying cause, and resulted in hemodynamic instability in 40% of VT-LVAD <5 patients vs. 50% in VT-LVAD 5 (p=0.44). Long-term mortality was similar for VT-LVAD <5 and 5 respectively (21.7% vs. 37.0%, p=0.59) and there
Summary
Keywords
Heart FaiIure, heartfailure, ICD, LVAD (left ventricular assist device), Ventricular arhythmias
Received
16 September 2025
Accepted
09 February 2026
Copyright
© 2026 Massie, Boulet, De Marco, Noly, Lamarche, Mondesert and Ducharme. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Anique Ducharme
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