Contemporary Management of Cardiac Implantable Electronic Devices in the LVAD Era: Evidence, Controversies, and Clinical Implications

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

It is quite a comprehensive review on a controversial subject. As a matter of fact, the question remains: Do we really need ICDs in LVAD patients?

Here are some comments and suggestions.

 

Page 2, line 55: replace “inelegibles” with “ineligible”.

 

Page 4, line 160-161: “...with a mean follow-up of 4.4    2.8 years.” This line is not clear; it looks as if something is missing.

 

Page 6, line 266: replace “benefits of survival” with “benefits on survival”.

 

Page 7, line 287: it would be more appropriate to say “...and the decision should be tailored according to the needs.”

 

Page 8, line 330: it would be more appropriate to say “...there is no evidence that ICD shocks damage the LVAD hardware...”

 

Page 9, line 399: it would be more appropriate to say “If an ICD/CRT generator reaches the end of life...”

 

Page 10, line 433: it would be more appropriate to say “The statement clearly confirms that...”

 

Page 10, line 456-457: it would be more appropriate to say “They suggest that in patients who did not undergo an ICD insertion previously, an individualised approach is needed...”

 

 

Author Response

Dear reviewer,

I sincerely thank you for your thorough review of our manuscript and for your constructive and insightful comments; i appreciate the time and effort you dedicated to improve our work. 

I have carefully considered all your suggestions and have revised the manuscript accordingly. 

All the points you raised, have been addressed and incorporated into the revised version. 

Thank you again for your valuable feedback.

Kind regards,

G. Sgarito.

Reviewer 2 Report

Comments and Suggestions for Authors

Sgarito et al. present a review on permanent left ventricular assist devices in combination with implanted antiarrhythmic devices and aggregates for resynchronization therapy.

Since these combinations are not only possible but also common today, such an overview seems entirely reasonable.

The review describes in detail not only the usefulness of ICD in the context of LVAD, but also the reasons why it may be necessary. Possibilities for effective programming options are also presented here, including meaningful deactivation.

It is explained in detail that the implantation of such devices is not necessarily free of complications. A critical discussion of the risks arising from device therapy, as well as the problems associated with this particular patient group, is presented.

All in all, this is an overview that considers almost all aspects of this topic and yet remains within acceptable limits in terms of the length of the text.

Author Response

Dear Reviewer, 

I sincerely thank you for taking the time to review our manuscript and for your positive and encouraging comment. 

I truly appreciate your valuable feedback and I'm grateful that you confirmed that no substantial revisions are required. 

Kind regards, 

G. Sgarito. 

"Sgarito et al. present a review on permanent left ventricular assist devices in combination with implanted antiarrhythmic devices and aggregates for resynchronization therapy. Since these combinations are not only possible but also common today, such an overview seems entirely reasonable.The review describes in detail not only the usefulness of ICD in the context of LVAD, but also the reasons why it may be necessary. Possibilities for effective programming options are also presented here, including meaningful deactivation.It is explained in detail that the implantation of such devices is not necessarily free of complications. A critical discussion of the risks arising from device therapy, as well as the problems associated with this particular patient group, is presented.All in all, this is an overview that considers almost all aspects of this topic and yet remains within acceptable limits in terms of the length of the text."