Wearable cardioverter defibrillator multicentre experience in a large cardiac surgery cohort at transient risk of sudden cardiac death

Kuehn, Christian; Ruemke, Stefan; Rellecke, Philipp; Lichtenberg, Artur; Jóskowiak, Dominik; Hagl, Christian; Hassan, Mohamed; Leyh, Rainer; Erler, Stefan; Garbade, Jens; Eifert, Sandra; Grieshaber, Philippe; Böning, Andreas; Doenst, Torsten; Velichkov, Ilia; Madej, T.; Knaut, Michael; Hain, Andreas; Bürger, H. C.

doi:10.1093/ejcts/ezac086

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…However, our study still gives valuable insight into the efficacy of the WCD in a real‐life setting. Moreover, our study supports the reported findings of a large German multi‐center study (Kuehn et al, 2022).…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

“…In this retrospective analysis from a single cardiac surgery center in Germany, safety, effectiveness, and compliance of WCD use were investigated in patients after cardiac surgery in a real-life setting. The presented data complement the study results of a recent, large German multi-center study reported by Kuehn et al [14] In post-surgical patients, the temporary use of WCD is particularly warranted in patients at high risk for SCD. In our study population, 50 (90.9%) patients had an LVEF ≤ 35% after surgery and were, therefore, by broad consensus, at high risk for SCD.…”

Section: Discussionsupporting

confidence: 86%

“…In four instances, shock delivery was not necessary, and VT episodes were, correctly, not treated. These findings on the effective delivery of shocks are in line with the recently published German multi-center study, which included 1168 patients using WCD after cardiac surgery (Kuehn et al, 2022). Therefore a prospective observational study was designed which should be completed in the next 5 years to address whether the patient's physical activity after the operation might influence the recovery of the myocardium.…”

Section: Discussionsupporting

confidence: 65%

“…German multi-center study reported by Kuehn et al (2022) In post-surgical patients, the temporary use of WCD is particularly warranted in patients at high risk for SCD. In our study population, 50 (90.9%) patients had an LVEF ≤35% after surgery and were, therefore, by broad consensus, at high risk for SCD.…”

Section: Discussionmentioning

confidence: 99%

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Wearable cardioverter defibrillator after cardiac surgery: Analysis of real‐life data from patients at transient risk of sudden cardiac death

Elbayomi

Weyand

Seitz

et al. 2023

Noninvasive Electrocardiol

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BackgroundEspecially in the rst 3 months after cardiac surgery, patients are at transient risk of sudden cardiac death (SCD). To close the gap between hospital discharge and the nal implantable cardioverter-de brillator (ICD) decision, guidelines recommend the temporary use of a wearable cardioverter-de brillator (WCD) to protect these patients from SCD. We investigated real-life data on the safety, effectiveness, and compliance of the WCD in this population. MethodsData for analysis were collected via the Zoll Patient Management Network (ZPM) from patients who underwent cardiac surgery and who were discharged with a WCD between 2018 and 2021 at the Cardiac Surgery Center of the University of Erlangen in Germany. ResultsThe majority of the 55 patients were male (90.9%) and underwent a coronary artery bypass graft (80.0%). The number of patients with left ventricular ejection fraction (LVEF) > 35% increased from 9.1% at the beginning of WCD use to 58.2% at the end of WCD use. 6 ventricular tachycardia (VT) episodes occurred in 4 patients. 2 patients with VT episodes were appropriately de brillated by the WCD. There were no inadequate shocks and no fatalities during the observation time. WCD wearing compliance was high with a median wear time of 23.3 hours/day. ConclusionThis retrospective analysis in a single cardiac surgery center con rms prior data on safety and effectiveness of the WCD in patients in post-surgery care in a real-life setting. The WCD successfully protected patients from SCD during life-threatening VT episodes. WCD wearing compliance was high.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Wearable cardioverter defibrillator after cardiac surgery: Analysis of real‐life data from patients at transient risk of sudden cardiac death

Elbayomi

Weyand

Seitz

et al. 2023

Noninvasive Electrocardiol

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Association of BMI with adherence and outcome in heart failure patients treated with wearable cardioverter defibrillator

Abumayyaleh,

Koepsel,

Erath

et al. 2024

ESC Heart Failure

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BackgroundObesity is a known risk factor for cardiovascular disease (CVD), yet an ‘obesity paradox’ has been observed in various CVD contexts. The impact of obesity on heart failure (HF) patients treated with a wearable cardioverter‐defibrillator (WCD) remains underexplored.MethodsIn a multicentre international registry, we retrospectively collected data from a consecutive series of 1003 patients. These patients were divided into three body mass index (BMI) groups: <25 kg/m2 (n = 348), 25–30 kg/m2 (n = 383), and >30 kg/m2 (n = 272), with BMI > 30 kg/m2 defined as the reference category. Demographics, indications, adherence, WCD shocks, arrhythmic events, rehospitalization due to cardiovascular causes, and mortality were analysed.ResultsAt 3 month follow‐up, patients with a BMI > 30 showed the greatest improvement in left ventricular ejection fraction (LVEF) at 51.4%, significantly higher than the 41.4% in those with a BMI < 25 (P = 0.017) and comparable with the 49.4% in the BMI 25–30 group (P = 0.635). WCD wearing time and adherence were similar across all BMI groups. The incidence of WCD shock was similar across BMI groups. Rates of ventricular tachycardia (VT), ventricular fibrillation and non‐sustained VT (ns‐VT) were comparable across BMI groups. The rate of implantable cardioverter‐defibrillator (ICD) implantation was 40.3% across all patients, with a slightly lower rate in the BMI > 30 group (36.8%) compared with others, although not significantly. Rehospitalization due to cardiovascular causes was significantly lower in the BMI > 30 group (55.4%) compared with the BMI 25–30 group (70.9%; P = 0.048), but similar to the BMI < 25 group (54.9%; P = 0.957). At 2 year follow‐up, mortality was lower in the BMI > 30 group (5.9%) compared with the BMI < 25 (7.5%; P = 0.029) and BMI 25–30 groups (7%; P = 0.681). In multivariable analysis, LVEF at long term was significantly associated with a reduction in mortality.ConclusionsObese patients exhibited significantly greater improvement in LVEF, which was associated with reduced mortality. Adherence to WCD therapy was excellent across all BMI groups. ICD implantation occurred in 40.3% of patients, with similar WCD shock rates and arrhythmic events across BMI groups. An obesity paradox was observed, with obese patients demonstrating significantly lower rehospitalization rates due to cardiovascular causes and reduced mortality at follow‐up.

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The Role of the Wearable Defibrillator in Heart Failure

Lenormand,

Bodin,

Fauchier

2024

Curr Heart Fail Rep

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Wearable cardioverter defibrillator multicentre experience in a large cardiac surgery cohort at transient risk of sudden cardiac death

Cited by 7 publications

References 28 publications

Wearable cardioverter defibrillator after cardiac surgery: Analysis of real‐life data from patients at transient risk of sudden cardiac death

Wearable cardioverter defibrillator after cardiac surgery: Analysis of real‐life data from patients at transient risk of sudden cardiac death

Association of BMI with adherence and outcome in heart failure patients treated with wearable cardioverter defibrillator

The Role of the Wearable Defibrillator in Heart Failure

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