Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices.
Christopher S Lee, Jill M Gelow, Christopher V Chien and 5 others
PMID 28591005WHAT IT FOUND
After LVAD implantation, quality of life, breathing, sleepiness, depression, and anxiety improved over 6 months in both groups.
Destination patients had larger early improvements in breathing, sleepiness, and quality of life; bridge patients continued improving breathing after 1 month.
Key findings
01Both bridge and destination patients had significant improvements in quality of life, dyspnea, wake disturbances, depression, and anxiety over 6 months.
02Destination patients had worse pre-implant dyspnea and wake disturbances and greater initial improvements in them than bridge patients.
03Destination patients had smaller early anxiety improvement and no anxiety improvement at 1 month, while bridge patients had no anxiety improvement after 1 month.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-center observational cohort, so it describes patterns rather than a tested treatment effect. The sample was 86 adults and mainly men, so results may not apply to women or other settings. Follow-up was only 6 months, so longer-term symptom changes are not described. Patients with major psychiatric illness, major cognitive impairment, or terminal illness were excluded. Bridge versus destination therapy was assigned by a committee, and the groups differed at baseline.
Declared interests
The PREMISE study was sponsored by the National Institutes of Health.
The easy way to misread this
Do not read these symptom improvements as proof that LVAD alone caused them. This was a single-center observational cohort with mainly men and only 6 months of follow-up.