Madhab Lamichhane1, Joseph C Gardiner2, Nicole R Bianco3, Steven J Szymkiewicz3, Ranjan K Thakur4. 1. Cardiovascular Disease Fellowship Program, Michigan State University/Sparrow Thoracic and Cardiovascular Institute, 1200 E Michigan Ave; Suite 580, East Lansing, MI, 48912, USA. 2. Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA. 3. ZOLL, Pittsburgh, PA, USA. 4. Cardiovascular Disease Fellowship Program, Michigan State University/Sparrow Thoracic and Cardiovascular Institute, 1200 E Michigan Ave; Suite 580, East Lansing, MI, 48912, USA. thakur@msu.edu.
Abstract
PURPOSE: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF). METHODS: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use. Cox-regression was used to identify factors associated with survival with WCD use, and reasons for stopping use were entered as time-dependent factors. RESULTS: Among 220 patients, age (mean ± SD) 55.4 ± 14.8 years, WCD use 451.4 ± 289.9 days, and 67.3 % were male and their left ventricle ejection fraction (EF) averaged 20.9 ± 7.2 %. Eighty-nine (40.5 %) were continuing WCD use at the last follow-up. Thirty-six (16.4 %) and 56 (25.5 %) patients discontinued WCD use because of EF recovery and implantable cardioverter (ICD) implantation, respectively. Nine patients (4.1 %) received appropriate shock therapy for 13 episodes of sustained ventricular tachyarrhythmia with 12 (92.3 %) successful shocks. One patient died of refractory ventricular fibrillation. One patient died from sinus bradycardia transitioning to asystole. Eight patients (3.6 %) had nine episodes of non-fatal inappropriate shocks. CONCLUSIONS: Long-term use of the WCD is safe and effective. Recovery of EF was seen in significant number of patients even after 1 year of WCD use.
PURPOSE: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF). METHODS: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use. Cox-regression was used to identify factors associated with survival with WCD use, and reasons for stopping use were entered as time-dependent factors. RESULTS: Among 220 patients, age (mean ± SD) 55.4 ± 14.8 years, WCD use 451.4 ± 289.9 days, and 67.3 % were male and their left ventricle ejection fraction (EF) averaged 20.9 ± 7.2 %. Eighty-nine (40.5 %) were continuing WCD use at the last follow-up. Thirty-six (16.4 %) and 56 (25.5 %) patients discontinued WCD use because of EF recovery and implantable cardioverter (ICD) implantation, respectively. Nine patients (4.1 %) received appropriate shock therapy for 13 episodes of sustained ventricular tachyarrhythmia with 12 (92.3 %) successful shocks. One patient died of refractory ventricular fibrillation. One patient died from sinus bradycardia transitioning to asystole. Eight patients (3.6 %) had nine episodes of non-fatal inappropriate shocks. CONCLUSIONS: Long-term use of the WCD is safe and effective. Recovery of EF was seen in significant number of patients even after 1 year of WCD use.
Authors: Clyde W Yancy; Mariell Jessup; Biykem Bozkurt; Javed Butler; Donald E Casey; Mark H Drazner; Gregg C Fonarow; Stephen A Geraci; Tamara Horwich; James L Januzzi; Maryl R Johnson; Edward K Kasper; Wayne C Levy; Frederick A Masoudi; Patrick E McBride; John J V McMurray; Judith E Mitchell; Pamela N Peterson; Barbara Riegel; Flora Sam; Lynne W Stevenson; W H Wilson Tang; Emily J Tsai; Bruce L Wilkoff Journal: J Am Coll Cardiol Date: 2013-06-05 Impact factor: 24.094
Authors: Helmut U Klein; Ulf Meltendorf; Sven Reek; Jan Smid; Sebastian Kuss; Iwona Cygankiewicz; Christian Jons; Steven Szymkiewicz; Frank Buhtz; Anke Wollbrueck; Wojciech Zareba; Arthur J Moss Journal: Pacing Clin Electrophysiol Date: 2009-11-02 Impact factor: 1.976
Authors: Arthur M Feldman; Helmut Klein; Patrick Tchou; Srinivas Murali; W Jackson Hall; Donna Mancini; John Boehmer; Mark Harvey; M Stephen Heilman; Steven J Szymkiewicz; Arthur J Moss Journal: Pacing Clin Electrophysiol Date: 2004-01 Impact factor: 1.976
Authors: Jeptha P Curtis; Seth I Sokol; Yongfei Wang; Saif S Rathore; Dennis T Ko; Farid Jadbabaie; Edward L Portnay; Stephen J Marshalko; Martha J Radford; Harlan M Krumholz Journal: J Am Coll Cardiol Date: 2003-08-20 Impact factor: 24.094
Authors: Patricia P Chang; Lloyd E Chambless; Eyal Shahar; Alain G Bertoni; Stuart D Russell; Hanyu Ni; Max He; Thomas H Mosley; Lynne E Wagenknecht; Tandaw E Samdarshi; Lisa M Wruck; Wayne D Rosamond Journal: Am J Cardiol Date: 2013-11-09 Impact factor: 2.778
Authors: Sumeet S Chugh; Jonathan Jui; Karen Gunson; Eric C Stecker; Benjamin T John; Barbara Thompson; Nasreen Ilias; Catherine Vickers; Vivek Dogra; Mohamud Daya; Jack Kron; Zhi-Jie Zheng; George Mensah; John McAnulty Journal: J Am Coll Cardiol Date: 2004-09-15 Impact factor: 24.094
Authors: Andrew C Kao; Steven W Krause; Rajiv Handa; Darshak Karia; Guillermo Reyes; Nicole R Bianco; Steven J Szymkiewicz Journal: BMC Cardiovasc Disord Date: 2012-12-12 Impact factor: 2.298
Authors: Ahmad Masri; Ahmed M Altibi; Sebhat Erqou; Mohammad A Zmaili; Ala Saleh; Raed Al-Adham; Karam Ayoub; Moaaz Baghal; Laith Alkukhun; Amr F Barakat; Sandeep Jain; Samir Saba; Evan Adelstein Journal: JACC Clin Electrophysiol Date: 2019-01-30