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- Title
Indications for and outcome in patients with the wearable cardioverter-defibrillator in a nurse-based training programme: results of the Austrian WCD Registry.
- Authors
Odeneg, Tanja; Ebner, Christian; Mörtl, Deddo; Keller, Hans; Dirninger, Alfred; Stix, Günter; Föger, Bernhard; Grimm, Georg; Steinwender, Clemens; Gebetsberger, Franz; Stühlinger, Markus; Mastnak, Bernadette; Haider, Christian; Manninger, Martin; Scherr, Daniel
- Abstract
Background: The wearable cardioverter-defibrillator is a treatment option for patients at temporarily high risk of sudden cardiac death or in whom implantation of a cardioverter-defibrillator is temporarily not possible. Objectives: The aim of this study was to provide real-world data on patients receiving this therapy in a nurse-based wearable cardioverter-defibrillator training programme. Methods: A registry including all patients prescribed with a wearable cardioverter-defibrillator in Austria between 2010 and 2016. Overall, 448 patients received a wearable cardioverter-defibrillator in 48 centres. Patients received structured nurse-based wearable cardioverter-defibrillator educational initial training followed by remote monitoring. Results: Main indications were: severe non-ischaemic cardiomyopathy (21%); recent myocardial infarction and percutaneous coronary intervention (20%); and stable coronary artery disease with percutaneous coronary intervention/coronary artery bypass grafting (14%). Eleven patients (2.5%) received 22 appropriate wearable cardioverter-defibrillator shocks. Two patients (0.4%) received three inappropriate shocks. The risk of sudden cardiac death varied between different aetiologies. Eight out of 11 (73%) patients received their first wearable cardioverter-defibrillator shock within 30 days. The main reasons for termination of the wearable cardioverter-defibrillator therapy were implantable cardioverter-defibrillator implantation (55.5%) and improvement of left ventricular ejection fraction to more than 35% (33%). Conclusion: The wearable cardioverter-defibrillator is an effective and safe treatment option in patients at either transiently elevated risk of ventricular tachycardia/ventricular fibrillation or mandated postponed implantable cardioverter-defibrillator implantation, with a 2.5% shock rate over a median 54 days wearable cardioverter-defibrillator treatment period. However, both the wearable cardioverter-defibrillator shock rate and implantable cardioverter-defibrillator implantation rate vary widely depending on the wearable cardioverter-defibrillator indication. Nurse-based wearable cardioverter-defibrillator training is associated with high patient adherence, with a median wearing duration per day of 23.5 (1–24) hours.
- Subjects
AUSTRIA; VENTRICULAR fibrillation; VENTRICULAR tachycardia; CARDIAC arrest; ARRHYTHMIA; CORONARY artery bypass; CORONARY disease; DEFIBRILLATORS; ELECTRIC countershock; ELECTROCARDIOGRAPHY; FISHER exact test; IMPLANTABLE cardioverter-defibrillators; MYOCARDIAL infarction; CARDIOMYOPATHIES; PATIENT compliance; PATIENT education; PATIENT safety; T-test (Statistics); TELEMEDICINE; WEARABLE technology; TREATMENT effectiveness; DATA analysis software; MANN Whitney U Test; KRUSKAL-Wallis Test; PERCUTANEOUS coronary intervention; NURSING interventions; VENTRICULAR ejection fraction; DISEASE risk factors; CARDIOVASCULAR diseases risk factors
- Publication
European Journal of Cardiovascular Nursing, 2019, Vol 18, Issue 1, p75
- ISSN
1474-5151
- Publication type
Article
- DOI
10.1177/1474515118790365