LAUSR

Introduction Digoxin use within the heart failure population remains controversial, as studies have suggested increased arrhythmia risk and lower survival. Despite decades of use in heart failure, little is known regarding digoxin utilization post-left ventricular assist device (LVAD). We aimed to evaluate if digoxin use impacts overall survival or incidence of right ventricular (RV) failure after LVAD implantation. Methods Analysis was performed on 320 patients who underwent LVAD implantation from 2004-2017 and survived to hospital discharge. Patients were divided into groups based on digoxin utilization at discharge following LVAD placement. RV failure was defined as a composite of central venous pressure > 16mmHg or need for inotropic medication post-discharge or admission for intravenous diuretic therapy. Survival was assessed via Kaplan-Meier method and compared via log-rank test. Between group differences were assessed using independent sample t-tests and Fisher's exact tests. Results The cohort (n=320) had an average age of 56.2 (±13) years and contained 70 (21.9%) female patients. A majority ((n=129 (60%)) were implanted as destination therapy with 112 (35%) patients prescribed digoxin at the time of discharge (See Figure 1). Patients on digoxin were more likely to have a non-ischemic cardiomyopathy (p=0.002), had higher pulmonary vascular resistance (PVR) (p=0.03), and had larger left ventricular (p Conclusions Despite concerns about its continued use in different heart failure populations, overall survival was similar in LVAD patients with and without digoxin use at the time of initial discharge. A trend of reduced RV failure was present with digoxin use. Further studies are needed to fully elucidate the optimal patient population that may benefit from digoxin use following LVAD implantation.