Combining nonpharmacologic therapies for advanced heart failure: the münster experience with the assist device–defibrillator combination

• Published in: The American journal of cardiology Vol. 83; no. 5; pp. 158 - 160
• Main Authors: Deng, Mario C, Tjan, Tonny D.T, Asfour, Boulos, Gradaus, Rainer, Böcker, Dirk, Loick, Heinz Michael, Baba, Hideo A, Breithardt, Günter, Scheld, Hans H, Borggrefe, Martin, Hammel, Dieter
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 11.03.1999; Elsevier; Elsevier Limited
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; Clinical trials; Combined Modality Therapy; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable; Female; Germany; Heart; Heart failure; Heart Failure - etiology; Heart Failure - mortality; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Transplantation; Heart-Assist Devices; Humans; Male; Medical sciences; Middle Aged; Retrospective Studies; Survival Rate; Therapy; Transplants & implants; Waiting Lists; Germany; Human; Heart failure; Intensive cardiocirculatory care; Cardiocirculatory support; Instrumentation therapy; Cardiovascular disease; Instrumentation; Case study; Treatment; Implanted; Heart disease; Auxiliary ventricule; Advanced stage; Technique; Defibrillation; Defibrillator
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(98)01018-2

Implantable cardioverter defibrillators (ICDs) and ventricular assist devices (VADs) have been used as a bridge to cardiac transplantation. In selected patients, the combined implantation may be required. This study was motivated by a case of a 33-year-old female patient with giant cell myocarditis who died of ventricular tachyarrhythmias after having been placed on a VAD with which she had been treated on an out-of-hospital basis for a prolonged period of time. A subsequent retrospective analysis of our data showed that, of 73 patients who had to be bridged mechanically (54 Novacor, 12 TCI Heartmate, 4 Thoratec, 3 Medos) in our institution between 1993 and 1998, 10 patients had undergone defibrillator implantation either before (n = 8) or after (n = 2) implantation of a VAD. The cases are presented, and the feasibility of the combination therapy discussed.