Real-world experience with the wearable cardioverter defibrillator: clinical effectiveness and wear-time adherence in patients at high risk for sudden cardiac death
- 25.10.2021
- Original Contributions
Erschienen in:
- Verfasst von
- Dr. Christian Weth
- Hasan Abuazab
- Sebastian Ewen
- Christian Ukena
- Michael Böhm
- Florian Custodis
- Erschienen in
- Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 1/2022
Abstract
Background
Previous studies established a role for the wearable cardioverter defibrillator (WCD) to effectively and safely bridge temporary risk for sudden cardiac death (SCD) in patients with advanced heart failure. The prognostic relevance of the WCD remains controversial.
Objectives
The authors investigated adherence to, as well as the safety and effectiveness of, WCD use in a real-world cohort of patients at high risk for SCD.
Material and methods
All consecutive patients (n = 83) receiving a WCD at a German tertiary care hospital between April 2012 and December 2019 were retrospectively included in this analysis. Patient characteristics were collected at the time of the index hospitalization. Using the Zoll® lifeVest® (ZOLL Medical Corporation, Chelmsford, MA, USA) network database, two separate investigators evaluated adherence to the WCD as well as arrhythmic events during WCD wear time.
Results
During 3680 wearing days (mean WCD wear time, 44 days) with a median daily wear time of 23.1 h, three arrhythmic events of relevance (sustained ventricular tachycardia, VT) occurred, one of which was sufficiently terminated by WCD shock. Another patient died from sudden cardiac death while pausing his WCD. Right bundle branch block correlated significantly with sustained VT occurrence (r = 0.3315; 95% CI −0.1265 to 0.3014; p = 0.0022). In 30 patients (36.1%) a cardioverter/defibrillator was implanted.
Conclusion
In a real-life clinical setting, the use of WCD in patients at high risk for sudden cardiac death is effective and safe and adherence to the device is high. The event rate for VA was lower than in comparable patient cohorts. Adherence remains a crucial issue as one patient in the present series died while not wearing the device.
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- Titel
- Real-world experience with the wearable cardioverter defibrillator: clinical effectiveness and wear-time adherence in patients at high risk for sudden cardiac death
- Verfasst von
-
Dr. Christian Weth
Hasan Abuazab
Sebastian Ewen
Christian Ukena
Michael Böhm
Florian Custodis
- Publikationsdatum
- 25.10.2021
- Verlag
- Springer Medizin
- Erschienen in
-
Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 1/2022
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544 - DOI
- https://doi.org/10.1007/s00399-021-00816-w
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