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. 2020 Nov-Dec;34(6):3601-3610.
doi: 10.21873/invivo.12205.

Comparison of the Outcome of Patients Protected by the Wearable Cardioverter Defibrillator (WCD) for <90 Wear Days versus ≥90 Wear Days

Tobias C Dreher #  1 , Ibrahim El-Battrawy #  2   3 , Susanne RÖger  2   3 , Stephanie L Rosenkaimer  2   3 , Stefan Gerhards  2   3 , JÜrgen Kuschyk  2   3 , Martin Borggrefe  2   3 , Ibrahim Akin  2   3
Affiliations

Comparison of the Outcome of Patients Protected by the Wearable Cardioverter Defibrillator (WCD) for <90 Wear Days versus ≥90 Wear Days

Tobias C Dreher et al. In Vivo. 2020 Nov-Dec.

Abstract

Background/aim: The wearable cardioverter/defibrillator (WCD) is recommended to prevent sudden cardiac death (SCD). Guidelines suggest a 90 days' period, but prolongation of WCD wear time until increasing the ejection fraction (≥35%) might be suggested.

Patients and methods: A cohort of 153 patients with prescribed WCD were divided into two groups: A <90 wear days' group (n=112) vs. ≥90 wear days' group (n=41) and followed.

Results: In the first group, WCD shock occurred in 3.6% of patients, 47.3% improved in left ventricular ejection fraction (LVEF) after 3 months, and 37.5% had a cardiac implantable electronic device (CIED) implantation with appropriate implantable cardioverter defibrillator (ICD) shock events occurring in 6 patients. Two of these patients already received WCD shock therapy due to ventricular fibrillation. A 20.5% improved in LVEF after 6-12 months, but 73% were already implanted with ICD. In the second group, 4.9% received WCD shock, 34.1% improved in LVEF after 3 months, 48.8% were implanted with ICD, and 2 had ICD shocks during follow up time. LVEF improvement after 6-12 months occurred in 26.8%. ICD implantation was prevented in 7.3% of patients due to LVEF recovery.

Conclusion: Prolonging wearing days of WCD may reduce the number of inappropriate ICD implantation.

Keywords: Wearable cardioverter defibrillator (WCD); heart insufficiency; sudden cardiac death.

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Conflict of interest statement

All Authors declare that there are no conflicts of interest regarding this study.

Figures

Figure 1
Figure 1. Indications for wearable cardioverter defibrillator (WCD) use
Figure 2
Figure 2. Comparison of wear days and wearable cardioverter defibrillator (WCD) shock therapy
Figure 3
Figure 3. Comparison of wear days and device implantation
See this image and copyright information in PMC

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