BACKGROUND: In patients with a continuous-flow left ventricular assist device, preimplant predictors of poor physical performance are not well-described. We aimed to identify predictors of inability to walk more than 300 m on 6-minute walk test (6MWT) 6 months after HeartMate 3 implantation. METHODS AND RESULTS: Using data from the European Registry of Patients Implanted With a Full Magnetically Levitated LVAD, patients with available 6MWT at 6 months after implantation were included (N = 194) and grouped according to 6MWT distance (6MWD) of >300 m (n = 150) or 6MWD of <300 m (n = 44). Patients walking <300 m were older (60 ± 10 vs 52 ± 12 years; P < .001), more often New York Heart Association functional class IV (63% vs 42%; P = .03), and more often had type 2 diabetes (43% vs 17%; P < .001) at implantation. Atrial fibrillation was seen in 57% in those with a 6MWT of <300 m vs 31% in those walking longer (P < .002). Further, hemoglobin and estimated glomerular filtration rate was lower in those walking <300 m (both P < .01). In multivariable regression analysis, independent predictors of a 6MWD of <300 m were: atrial fibrillation (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.12-8.67), older age (OR for 10-year increment, 2.81; 95% CI, 1.55-5.07), New York Heart Association functional class IV (OR, 3.37; 95% CI, 1.27-8.98), and Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2 (OR, 6.53; 95% CI, 1.92-22.19). CONCLUSIONS: Six months after HeartMate 3 implantation, 77% of patients walked >300 meters in 6 minutes. Apart from age and measures of heart failure severity, atrial fibrillation at implantation is an independent predictor of low 6MWD at 6 months after implantation.

Abbott Chicago Illinois

Department of Cardiology Rigshospitalet University of Copenhagen Denmark

Department of Cardiology Rigshospitalet University of Copenhagen Denmark; Department of Clinical Medicine University of Copenhagen Denmark

Department of Cardiothoracic Surgery Herz und Diabeteszentrum NRW Bad Oeynhausen Germany

Department of Cardiothoracic Transplantation and Vascular Surgery Medizinische Hochschule Hannover Hannover Germany

Department of Surgery Division of Cardiac Surgery Medical University of Vienna Vienna Austria

Heart Transplantation Unit Leviev Heart Center Sheba Medical Center and Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

Herzchirurgie Herz und Gefäßklinik Bad Neustadt Bad Neustadt Germany

Institute for Clinical and Experimental Medicine Prague Czech Republic

Manchester University NHS Foundation Trust Southmoor Road Manchester UK

National Research Center for Cardiac Surgery Astana Kazakhstan

University Department for Cardiac Surgery Leipzig Heart Center Leipzig Germany

University Department for Cardiac Surgery Leipzig Heart Center Leipzig Germany; Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Berlin Germany; DZHK partner site Berlin Berlin Germany

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