Subcutaneous implantable cardioverter-defibrillator noise following left ventricular assist device implantation

Banveet Kaur Khetarpal, Awad Javaid, Justin Z. Lee, Fred Kusumoto, Siva K. Mulpuru, Dan Sorajja, Yong Mei Cha, Komandoor Srivathsan

Research output: Contribution to journalArticlepeer-review


Background: The incidence and impact of noise in a subcutaneous implantable cardioverter defibrillator (S-ICD) after left ventricular assist device (LVAD) implantation is not well established. Methods: We performed a retrospective study of patients implanted with LVAD and with a pre-existing S-ICD between January 2005 and December 2020 at the three Mayo Clinic centers (Minnesota, Arizona, and Florida). Results: Of the 908 LVAD patients, a pre-existing S-ICD was present in 9 patients (mean age 49.1 ± 13.7 years, 66.7% males), 100% with Boston Scientific third-generation EMBLEM MRI S-ICD, 11% with HeartMate II (HM II), 44% with HeartMate 3 (HM 3), and 44% with HeartWare (HW) LVAD. The incidence of noise from LVAD-related electromagnetic interference (EMI) was 33% and was only seen with HM 3 LVAD. Multiple measures attempted to resolve noise, including using alternative S-ICD sensing vector, adjusting S-ICD time zone, and increasing LVAD pump speed, were unsuccessful, necessitating S-ICD device therapies to be turned off permanently. Conclusions: The incidence of LVAD-related S-ICD noise is high in patients with concomitant LVAD and S-ICD with significant impact on device function. As conservative management failed to resolve the EMI, the S-ICDs had to be programmed off to avoid inappropriate shocks. This study highlights the importance of awareness of LVAD-SICD device interference and the need to improve S-ICD detection algorithms to eliminate noise.

Original languageEnglish (US)
Pages (from-to)198-206
Number of pages9
Journaljournal of arrhythmia
Issue number2
StatePublished - Apr 2023


  • electromagnetic interference
  • left ventricular assist device
  • oversensing
  • subcutaneous implantable cardioverter defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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