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. 2024 Mar 1;44(2):115-120.
doi: 10.1097/HCR.0000000000000832. Epub 2023 Nov 30.

Cardiovascular Rehabilitation With a WCD-Data From the CR3 Study (Cardiac Rehab Retrospective Review)

Ursula Rohrer  1 , Anja Reischl, Martin Manninger, Ronald K Binder, Lukas Fiedler, Michael Gruska, Johann Altenberger, Andreas Dorr, Clemens Steinwender, Markus Stuehlinger, Manfred Wonisch, Birgit Zirngast, David Zweiker, Andreas Zirlik, Daniel Scherr; Austrian WCD Study Group
Affiliations

Cardiovascular Rehabilitation With a WCD-Data From the CR3 Study (Cardiac Rehab Retrospective Review)

Ursula Rohrer et al. J Cardiopulm Rehabil Prev. .

Abstract

Purpose: Patients at risk for sudden cardiac death may temporarily need a wearable cardioverter-defibrillator (WCD). Exercise-based cardiac rehabilitation (CR) has a class I recommendation in patients with cardiac disease. The aim of this study was to evaluate the safety and feasibility of undergoing CR with a WCD.

Methods: We performed a retrospective analysis of all patients with a WCD who completed a CR in Austria (2010-2020).

Results: Patients (n = 55, 60 ± 11 yr, 16% female) with a median baseline left ventricular ejection fraction (LVEF) of 36 (30, 41)% at the start of CR showed a daily WCD wearing duration of 23.4 (22, 24) hr. There were 2848 (8 [1, 26]/patient) automatic alarms and 340 (3 [1, 7]/patient) manual alarms generated. No shocks were delivered by the WCD during the CR period. One patient had recurrent hemodynamically tolerated ventricular tachycardias that were controlled with antiarrhythmic drugs.No severe WCD-associated adverse events occurred during the CR stay of a median 28 (28, 28) d. The fabric garment and the device setting needed to be adjusted in two patients to diminish inappropriate automatic alarms. Left ventricular ejection fraction after CR increased significantly to 42 (30, 44)% ( P < .001). Wearable cardioverter-defibrillator therapy was stopped due to LVEF restitution in 53% of patients. In 36% of patients an implantable cardioverter-defibrillator was implanted, 6% had LVEF improvement after coronary revascularization, one patient received a heart transplantation (2%), two patients discontinued WCD treatment at their own request (4%).

Conclusion: Completing CR is feasible and safe for WCD patients and may contribute positively to the restitution of cardiac function.

Trial registration: ClinicalTrials.gov NCT04675957.

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Conflict of interest statement

D.S. received a research grant from ZOLL CMS for this study, all other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Underlying cardiac disease as a reason for wearable cardioverter-defibrillator prescription in 55 patients: 27 (49%) with ischemic cardiomyopathy, 15 (27%) with dilatative CMP, 10 (18%) with myocarditis, and each one patient with Takotsubo CMP, primary electrical disease, and valvular CMP (6%). Abbreviation: CMP, cardiomyopathy. This figure is available in color online (www.jcrpjournal.com).
Figure 2.
Figure 2.
Increase in LVEF from the time point of prescription (median LVEF 36% [11]) compared with LVEF at the end of WCD wearing period (median 94 d [67], median LVEF 42% [12]); (P < .0001). Abbreviations: LVEF, left ventricular ejection fraction; WCD, wearable cardioverter defibrillator. This figure is available in color online (www.jcrpjournal.com).
See this image and copyright information in PMC

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