The wearable cardioverter-defibrillator

• Verfasst von: Rosenkaimer, Stephanie L. [VerfasserIn]
• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Dreher, Tobias C. [VerfasserIn]
• Verfasst von: Gerhards, Stefan [VerfasserIn]
• Verfasst von: Röger, Susanne [VerfasserIn]
• Verfasst von: Kuschyk, Jürgen [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: The wearable cardioverter-defibrillator
• Titelzusatz: experience in 153 patients and a long-term follow-up
• Verf.angabe: Stephanie L. Rosenkaimer, Ibrahim El-Battrawy, Tobias C. Dreher, Stefan Gerhards, Susanne Röger, Jürgen Kuschyk, Martin Borggrefe and Ibrahim Akin
• E-Jahr: 2020
• Jahr: 24 March 2020
• Umfang: 15 S.
• Fussnoten: Gesehen am 10.12.2020
• Titel Quelle: Enthalten in: Journal of Clinical Medicine
• Ort Quelle: Basel : MDPI, 2012
• Jahr Quelle: 2020
• Band/Heft Quelle: 9(2020,3) Artikel-Nummer 893, 15 Seiten
• ISSN Quelle: 2077-0383
• DOI: doi:10.3390/jcm9030893
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: life-vest
• Sach-SW: sudden cardiac death
• Sach-SW: WCD
• K10plus-PPN: 1742422918
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background: The wearable cardioverter-defibrillator (WCD) is available for patients at high risk for sudden cardiac death (SCD) when immediate implantable cardioverter-defibrillator (ICD) implantation is not possible or indicated. Patient selection remains challenging especially in primary prevention. Long-term data on these patients is still lacking. Methods: 153 patients were included in this study. They were prescribed the WCD between April 2012 and March 2019 at the University Medical Center, Mannheim, Germany. The mean follow-up period was 36.2 ± 15.6 months. Outcome data, including all-cause mortality, were analyzed by disease etiology and ICD implantation following WCD use. Results: We analyzed 56 patients with ischemic cardiomyopathy, 70 patients with non-ischemic cardiomyopathy, 16 patients with prior need for ICD/CRT-D (device for cardiac resynchronization therapy with defibrillator) explanation, 8 patients with acute myocarditis and 3 patients with congenital diseases. 58% of the patients did not need ICD/CRT-D implantation after WCD use. 4% of all patients suffered from appropriate WCD shocks. 2 of these patients (33%) experienced appropriate ICD shocks after implantation due to ventricular tachyarrhythmias. Long-term follow-up shows a good overall survival. All-cause mortality was 10%. There was no significant difference between patients with or without subsequent ICD implantation (p = 0.48). Patients with ischemic cardiomyopathy numerically showed a higher long-term mortality than patients with non-ischemic cardiomyopathy (14% vs. 6%, p = 0.13) and received significantly more ICD shocks after implantation (10% of ischemic cardiomyopathy (ICM) patients versus 3% of non-ischemic cardiomyopathy (NICM) patients, p = 0.04). All patients with ventricular tachyarrhythmias during WCD use or after ICD implantation survived the follow-up period. Conclusion: Following WCD use, ICD implantation could be avoided in 58% of patients. Long-term follow-up shows good overall survival. The majority of all patients did not suffer from WCD shocks nor did receive ICD shocks after subsequent implantation. Patient selection regarding predictive conditions on long-term risk of ventricular tachyarrhythmias needs further risk stratification.