Comparison of Outcomes and Mortality in Patients Having Left Ventricular Assist Device Implanted Early -vs- Late After Diagnosis of Cardiomyopathy.

Abstract LVAD implantation in patients with a recently diagnosed cardiomyopathy has been poorly investigated. This work aims at describing the characteristics and outcomes of patients receiving a LVAD within 30 days following the diagnosis of cardiomyopathy. Patients from the ASSIST-ICD study were divided into recently and remotely diagnosed cardiomyopathy based on the time from initial diagnosis of cardiomyopathy to LVAD implantation using the cut point of 30 days. The primary endpoint of the study was all-cause mortality at 30-days and during follow-up. A total of 652 patients were included and followed during a median time of 9.1 (2.5-22.1) months. Among this population, 117 (17.9%) had a recently diagnosed cardiomyopathy and had LVAD implantation after a median time of 15.0 (9.0-24.0) days following the diagnosis. This group of patients was significantly younger, with more ischemic cardiomyopathy, more sudden cardiac arrest (SCA) events at the time of the diagnosis and were more likely to receive temporary mechanical support prior to LVAD compared to the remotely diagnosed group. Post-operative in-hospital survival was similar among groups, but recently diagnosed patients had a better long-term survival after hospital discharge. SCA prior to LVAD and any cardiac surgery combined with LVAD implantation were identified as two independent predictors of post-operative mortality in recently diagnosed patients. In conclusion, rescue LVAD implantation for recently diagnosed severe cardiomyopathy is common in clinical practice. Such patients experience a relatively low post-operative mortality and have a better long-term survival compared to remotely diagnosed patients.