Tanja Odeneg1, Christian Ebner2, Deddo Mörtl3, Hans Keller4, Alfred Dirninger5, Günter Stix6, Bernhard Föger7, Georg Grimm8, Clemens Steinwender9,10, Franz Gebetsberger11, Markus Stühlinger12, Bernadette Mastnak1, Christian Haider1, Martin Manninger1, Daniel Scherr1,13. 1. 1 Department of Cardiology, Medical University of Graz, Austria. 2. 2 Department of Cardiology, Elisabethinen Hospital Linz, Austria. 3. 3 Department of Medicine, University Hospital St Poelten, Austria. 4. 4 Department of Medicine Rudolfstifung Vienna, Austria. 5. 5 Department of Medicine, Hospital Hochsteiermark, Austria. 6. 6 Department of Cardiology, Medical University of Vienna, Austria. 7. 7 Department of Medicine, Hospital Bregenz, Austria. 8. 8 Department of Medicine and Cardiology, Hospital Klagenfurt, Austria. 9. 9 Department of Cardiology, Kepler University Hospital Linz, Austria. 10. 10 Paracelsus Medical University Salzburg, Austria. 11. 11 Department of Medicine, Hospital Steyr, Austria. 12. 12 Department of Medicine, Medical University of Innsbruck, Austria. 13. 13 Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, The Netherlands.
Abstract
BACKGROUND: The wearable cardioverter-defibrillator is a treatment option for patients at temporarily high risk of sudden cardiac death or in whom implantation of a cardioverter-defibrillator is temporarily not possible. OBJECTIVES: The aim of this study was to provide real-world data on patients receiving this therapy in a nurse-based wearable cardioverter-defibrillator training programme. METHODS: A registry including all patients prescribed with a wearable cardioverter-defibrillator in Austria between 2010 and 2016. Overall, 448 patients received a wearable cardioverter-defibrillator in 48 centres. Patients received structured nurse-based wearable cardioverter-defibrillator educational initial training followed by remote monitoring. RESULTS: Main indications were: severe non-ischaemic cardiomyopathy (21%); recent myocardial infarction and percutaneous coronary intervention (20%); and stable coronary artery disease with percutaneous coronary intervention/coronary artery bypass grafting (14%). Eleven patients (2.5%) received 22 appropriate wearable cardioverter-defibrillator shocks. Two patients (0.4%) received three inappropriate shocks. The risk of sudden cardiac death varied between different aetiologies. Eight out of 11 (73%) patients received their first wearable cardioverter-defibrillator shock within 30 days. The main reasons for termination of the wearable cardioverter-defibrillator therapy were implantable cardioverter-defibrillator implantation (55.5%) and improvement of left ventricular ejection fraction to more than 35% (33%). CONCLUSION: The wearable cardioverter-defibrillator is an effective and safe treatment option in patients at either transiently elevated risk of ventricular tachycardia/ventricular fibrillation or mandated postponed implantable cardioverter-defibrillator implantation, with a 2.5% shock rate over a median 54 days wearable cardioverter-defibrillator treatment period. However, both the wearable cardioverter-defibrillator shock rate and implantable cardioverter-defibrillator implantation rate vary widely depending on the wearable cardioverter-defibrillator indication. Nurse-based wearable cardioverter-defibrillator training is associated with high patient adherence, with a median wearing duration per day of 23.5 (1-24) hours.
BACKGROUND: The wearable cardioverter-defibrillator is a treatment option for patients at temporarily high risk of sudden cardiac death or in whom implantation of a cardioverter-defibrillator is temporarily not possible. OBJECTIVES: The aim of this study was to provide real-world data on patients receiving this therapy in a nurse-based wearable cardioverter-defibrillator training programme. METHODS: A registry including all patients prescribed with a wearable cardioverter-defibrillator in Austria between 2010 and 2016. Overall, 448 patients received a wearable cardioverter-defibrillator in 48 centres. Patients received structured nurse-based wearable cardioverter-defibrillator educational initial training followed by remote monitoring. RESULTS: Main indications were: severe non-ischaemic cardiomyopathy (21%); recent myocardial infarction and percutaneous coronary intervention (20%); and stable coronary artery disease with percutaneous coronary intervention/coronary artery bypass grafting (14%). Eleven patients (2.5%) received 22 appropriate wearable cardioverter-defibrillator shocks. Two patients (0.4%) received three inappropriate shocks. The risk of sudden cardiac death varied between different aetiologies. Eight out of 11 (73%) patients received their first wearable cardioverter-defibrillator shock within 30 days. The main reasons for termination of the wearable cardioverter-defibrillator therapy were implantable cardioverter-defibrillator implantation (55.5%) and improvement of left ventricular ejection fraction to more than 35% (33%). CONCLUSION: The wearable cardioverter-defibrillator is an effective and safe treatment option in patients at either transiently elevated risk of ventricular tachycardia/ventricular fibrillation or mandated postponed implantable cardioverter-defibrillator implantation, with a 2.5% shock rate over a median 54 days wearable cardioverter-defibrillator treatment period. However, both the wearable cardioverter-defibrillator shock rate and implantable cardioverter-defibrillator implantation rate vary widely depending on the wearable cardioverter-defibrillator indication. Nurse-based wearable cardioverter-defibrillator training is associated with high patient adherence, with a median wearing duration per day of 23.5 (1-24) hours.
Entities:
Keywords:
ICD; Lifevest; Wearable defibrillator; arrhythmia; sudden cardiac death
Authors: Christian Kuehn; Stefan Ruemke; Philipp Rellecke; Artur Lichtenberg; Dominik Joskowiak; Christian Hagl; Mohamed Hassan; Rainer G Leyh; Stefan Erler; Jens Garbade; Sandra Eifert; Philippe Grieshaber; Andreas Boening; Torsten Doenst; Ilia Velichkov; Tomas Madej; Michael Knaut; Andreas Hain; Heiko Burger Journal: Eur J Cardiothorac Surg Date: 2022-05-02 Impact factor: 4.534
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