Background: Patients with left ventricular ejection fraction (LVEF) ≤ 35% are at a high risk of sudden cardiac death (SCD) and benefit from implantable cardioverter-defibrillator (ICD) therapy. ICD implantation is no...Background: Patients with left ventricular ejection fraction (LVEF) ≤ 35% are at a high risk of sudden cardiac death (SCD) and benefit from implantable cardioverter-defibrillator (ICD) therapy. ICD implantation is not indicated during the first 40 days after acute myocardial infarction and <3 months after coronary artery bypass grafting, because of possible cardiac function recovery. The wearable cardioverter defibrillator (WCD) is a therapy option for preventing sudden cardiac death at the time of recovery. This study evaluated the effectiveness of the wearable cardioverter-defibrillator in preventing SCD after cardiac surgery. Methods: This is a retrospective study conducted in the Heart Center in Cottbus. From 02.2015 through 02.2018 26 WCD patients were retrospectively analyzed and followed-up. Patient demographics, defibrillation treatments, and daily wear times were retrospectively obtained from our clinical database and LifeVest network. The patients were questioned about actual NYHA grade and implanted ICD at the end of follow-up. Results: Twenty-five patients (mean age 65, 22 men, 3 women) were treated with a WCD in response to heart failure (mean EF = 24%) after cardiac surgery (21 CABG, 1 AVR, 1 AVR + CABG, 1 AVR + MVR, MVR + CABG). Average daily use of a WCD was 22.1 (SD ± 2.7) hours which were worn for 85 days (SD ± 35). At that time 11.96 (SD ± 15) events were detected but not treated, 1 defibrillation performed and no asystole seen. At the end of follow-up (12 months, SD ± 9) 20 patients were questioned. All of the patients were alive and 5 (25%) of them were with implanted ICD. 10 (50%) patients were in NYHA grade I, 3 (12%) in NYHA grade II, 3 (12%) between grade II-III, 2 (8%) in grade III and 2 (8%) patients in NYHA grade IV. Conclusions: A WCD is an effective therapy for prevention of sudden cardiac death during the recovery period of heart function after cardiac surgery. This is treatment with high patient compliance.展开更多
AIM To examine whether wearable cardioverter defibrillator(WCD) alarms for asystole improve patient outcomes and survival.METHODS All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a ...AIM To examine whether wearable cardioverter defibrillator(WCD) alarms for asystole improve patient outcomes and survival.METHODS All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a database of device and medical record documentation and customer call reports. Events were classified as asystole episodes if initial presenting arrhythmia was asystole(< 10 beats/minor ≥ 5 s pause). Survival was defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. Episodes occurring in hospitals, nursing homes, or ambulances were considered to be under medical care. Serious asystole episodes were defined as resulting in unconsciousness, hospital transfer, or death.RESULTS Of the total 51933 patients having worn the WCD in 2013, there were 257 patients(0.5%) who had asystole episodes and comprised the study cohort. Among the 257 patients(74% male, median age 69 years), there were 264 asystole episodes. Overall patient survival was 42%. Most asystoles were considered "serious"(n = 201 in 201 patients, 76%), with a 26% survival rate. All 56 patients with "non-serious" asystole episodes survived. Being under medical care was associated with worse survival of serious asystoles. Among acute survivors, 20% later died during WCD use(a median 4 days post asystole episode). Of the 86 living patients at the end of WCD use period, 48(56%) received ICD/pacemaker and 17(20%) improved their condition.CONCLUSION Survival rates after asystole in patients with WCD are higher than historically reported survival rates. Those under medical care at time of asystole exhibited lower survival.展开更多
文摘Background: Patients with left ventricular ejection fraction (LVEF) ≤ 35% are at a high risk of sudden cardiac death (SCD) and benefit from implantable cardioverter-defibrillator (ICD) therapy. ICD implantation is not indicated during the first 40 days after acute myocardial infarction and <3 months after coronary artery bypass grafting, because of possible cardiac function recovery. The wearable cardioverter defibrillator (WCD) is a therapy option for preventing sudden cardiac death at the time of recovery. This study evaluated the effectiveness of the wearable cardioverter-defibrillator in preventing SCD after cardiac surgery. Methods: This is a retrospective study conducted in the Heart Center in Cottbus. From 02.2015 through 02.2018 26 WCD patients were retrospectively analyzed and followed-up. Patient demographics, defibrillation treatments, and daily wear times were retrospectively obtained from our clinical database and LifeVest network. The patients were questioned about actual NYHA grade and implanted ICD at the end of follow-up. Results: Twenty-five patients (mean age 65, 22 men, 3 women) were treated with a WCD in response to heart failure (mean EF = 24%) after cardiac surgery (21 CABG, 1 AVR, 1 AVR + CABG, 1 AVR + MVR, MVR + CABG). Average daily use of a WCD was 22.1 (SD ± 2.7) hours which were worn for 85 days (SD ± 35). At that time 11.96 (SD ± 15) events were detected but not treated, 1 defibrillation performed and no asystole seen. At the end of follow-up (12 months, SD ± 9) 20 patients were questioned. All of the patients were alive and 5 (25%) of them were with implanted ICD. 10 (50%) patients were in NYHA grade I, 3 (12%) in NYHA grade II, 3 (12%) between grade II-III, 2 (8%) in grade III and 2 (8%) patients in NYHA grade IV. Conclusions: A WCD is an effective therapy for prevention of sudden cardiac death during the recovery period of heart function after cardiac surgery. This is treatment with high patient compliance.
文摘AIM To examine whether wearable cardioverter defibrillator(WCD) alarms for asystole improve patient outcomes and survival.METHODS All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a database of device and medical record documentation and customer call reports. Events were classified as asystole episodes if initial presenting arrhythmia was asystole(< 10 beats/minor ≥ 5 s pause). Survival was defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. Episodes occurring in hospitals, nursing homes, or ambulances were considered to be under medical care. Serious asystole episodes were defined as resulting in unconsciousness, hospital transfer, or death.RESULTS Of the total 51933 patients having worn the WCD in 2013, there were 257 patients(0.5%) who had asystole episodes and comprised the study cohort. Among the 257 patients(74% male, median age 69 years), there were 264 asystole episodes. Overall patient survival was 42%. Most asystoles were considered "serious"(n = 201 in 201 patients, 76%), with a 26% survival rate. All 56 patients with "non-serious" asystole episodes survived. Being under medical care was associated with worse survival of serious asystoles. Among acute survivors, 20% later died during WCD use(a median 4 days post asystole episode). Of the 86 living patients at the end of WCD use period, 48(56%) received ICD/pacemaker and 17(20%) improved their condition.CONCLUSION Survival rates after asystole in patients with WCD are higher than historically reported survival rates. Those under medical care at time of asystole exhibited lower survival.
