Wearable defibrillator use in patients with high risk of sudden cardiac death: a brief report from a single center

Submitted: 4 April 2023
Accepted: 26 June 2023
Published: 11 July 2023
Abstract Views: 198
PDF: 91
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Devices such as implantable cardioverter defibrillators (ICDs) and wearable cardioverter defibrillators (WCDs) have opened up new paths in the treatment of Sudden Cardiac Death. Guidelines advocate ICD placement for primary prevention after at least three months of optimal medical therapy following the first diagnosis of heart failure with reduced FE from any cause, and at least 40 days after an acute myocardial infarction with FE 35% notwithstanding medication. In these and other cases documented in the guidelines, the use of a wearable defibrillator (WCD), a noninvasive device that guards against malignant arrhythmias while waiting for arrhythmic risk to be defined and medication therapy to be optimized, may be considered. In our Cardiology/Utic Department, we treated 26 patients with a preliminary indication for ICD implantation: the use of the WCD allowed us to swiftly put them in clinical safety, avoiding potentially fatal arrhythmias while waiting for pharmacological therapy to be optimized. At the end of the periodic follow-up, FE had normalized in ten patients, allowing them to avoid ICD. Only 10 of the 26 participants with WCD had a proven indication for final implantation. There were no fatalities or problems in any of the patients.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Agarwal M, Narcisse D, Khouzam N, Khouzam RN. Wearable cardioverter defibrillator "The Lifevest": device design, limitations, and areas of improvement. Curr Probl Cardiol 2018;43:45-55. DOI: https://doi.org/10.1016/j.cpcardiol.2017.04.002
Casolo G, Gulizia MM, Aschieri D, et al. Position paper ANMCO: Guida all’uso appropriato del defibrillatore indossabile nella pratica clinica per i pazienti ad elevato rischio transitorio di morte improvvisa. Giornale Italiano Cardiologia 2022;23.
Priori SG, Blomström-Lundqvist C, Mazzanti A, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015;36:2793-867. DOI: https://doi.org/10.1093/eurheartj/ehv316
Ponikowski, P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200. DOI: https://doi.org/10.1093/eurheartj/ehw128
Reek S, Burri H, Roberts PR, et al. The wearable cardioverter-defibrillator: current technology and evolving indications. Europace 2017;19:335-45. DOI: https://doi.org/10.1093/europace/euw180
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 2018;138:e210-71. DOI: https://doi.org/10.1161/CIR.0000000000000615
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599-726. DOI: https://doi.org/10.1093/eurheartj/ehab670
Frustaci A, Russo MA, Chimenti C. Randomized study on the efficacy of immunosuppressive therapy in patients with virus-negative inflammatory cardiomyopathy: the TIMIC study. Eur Heart J 2009;30:1995-2002. DOI: https://doi.org/10.1093/eurheartj/ehp249
Everitt MD, Verma A, Saarel EV. The wearable external cardiac defibrillator for cancer patients at risk for sudden cardiac death. Community Oncol 2011;8:400-3. DOI: https://doi.org/10.1016/S1548-5315(12)70086-4
Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022;43:3997-4126. DOI: https://doi.org/10.1093/eurheartj/ehac699
Sharma PS, Bordachar P, Ellenbogen KA. Indications and use of the wearable cardiac defibrillator. Eur Heart J 2017;38:258-67. DOI: https://doi.org/10.1093/eurheartj/ehw353
Arena G, Casolo G, Giaccardi M. Il defibrillatore indossabile: punto di incontro tra ultime evidenze scientifiche ed applicabilità clinica. Giornale Italiano di Cardiologia 2021;22:742-50.
Lackermair K, Schuhman C, Kubieniec M, et al. Impairment of quality of life among patients with wearable cardioverter defibrillator therapy (LifeVestD): A Preliminary Study BioMed Research International 2018;2018:6028494. DOI: https://doi.org/10.1155/2018/6028494
Olgin JE, Pletcher MJ, Vittinghoff E, et al. VEST Investigators. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med 2018;379:1205-15. DOI: https://doi.org/10.1056/NEJMoa1800781
Auricchio A, Klein H, Geller CJ, et al. Clinical efficacy of the wearable cardioverter-defibrillator in acutely terminating episodes of ventricular fibrillation. Am J Cardiol 1998;81:1253-6. DOI: https://doi.org/10.1016/S0002-9149(98)00120-9
Reek S, Geller JC, Meltendorf U, et al. Clinical efficacy of a wearable defibrillator in acutely terminating episodes of ventricular fibrillation using biphasic shocks. Pacing Clin Electrophysiol 2003;26:2016-22. DOI: https://doi.org/10.1046/j.1460-9592.2003.00311.x
Feldman AM, Klein H, Tchou P, et al. Use of a wearable defibrillator in terminating tachyarrhythmias in patients at high risk for sudden death: results of the WEARIT/BIROAD. Pacing Clin Electrophysiol 2004;27:4-9. DOI: https://doi.org/10.1111/j.1540-8159.2004.00378.x
Kutyifa V, Moss AJ, Klein H, et al. Use of the wearable cardioverter defibrillator in high-risk cardiac patients: data from the Prospective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry). Circulation 2015;132:1613-9. DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.015677
Röger S, Rosenkaimer SL, Hohneck A, et al. Therapy optimization in patients with heart failure: the role of the wearable cardioverter-defibrillator in a real-world setting. BMC Cardiovasc Disord 2018;18:52. DOI: https://doi.org/10.1186/s12872-018-0790-8
Botto GL, Mantovani LG, Cortesi PA, et al. The value of wearable cardioverter defibrillator in adult patients with recent myocardial infarction: Economic and clinical implications from a health technology assessment perspective. Int J Cardiol 2022;356:12-18. DOI: https://doi.org/10.1016/j.ijcard.2022.04.003

How to Cite

Russo, F., Russo, M. C., Riccio, G., Riccio, A., & Candurro, C. (2023). Wearable defibrillator use in patients with high risk of sudden cardiac death: a brief report from a single center. Acute Care Medicine Surgery and Anesthesia, 1(1). https://doi.org/10.4081/amsa.2023.14