Wearable Defibrillator Shows Benefits in Mortality
Survival seen after 90 percent of VT/VF events; patient compliance with device use is high
FRIDAY, July 9 (HealthDay News) -- Nationwide, wearable cardioverter-defibrillator (WCD) compliance is satisfactory, and use of the device is associated with low sudden death mortality, though asystole is an important cause of mortality, according to research published in the July 13 issue of the Journal of the American College of Cardiology.
Mina K. Chung, M.D., of the Cleveland Clinic, and colleagues analyzed data from 3,569 patients from a nationwide registry who wore the WCD for at least one day (average length of time, 52.6 days). Compliance and events were assessed, and survival was checked with the Social Security Death Index.
The researchers found that 52 percent of the patients used the device more than 90 percent of the day. Fifty-nine patients had 80 sustained ventricular tachycardia/ventricular fibrillation (VT/VF) events. First-shock success occurred in 99 percent of all VT/VF patients and 100 percent of unconscious VT/VF patients. Survival occurred in 90 percent of VT/VF events and 73.6 percent of all events. Asystole (in which 17 of 23 died), pulseless electrical activity, and respiratory arrest represented 24.5 percent of sudden cardiac arrests. Compared to first-time implantable cardioverter-defibrillator patients, long-term mortality was similar.
"In conclusion, the WCD is a technology that can save lives if prescribed for the correct patients. It has a high degree of success in treating ventricular tachyarrhythmias and does not appear to be very cumbersome for patient use. Not prescribing this lifesaving attire to your high-risk patient awaiting implantable cardioverter-defibrillator implantation or reimplantation is the real faux pas," writes the author of an accompanying editorial.
Several co-authors disclosed relationships with various medical device manufacturers, including ZOLL Cardiac Management Solutions, which employs one of the co-authors and makes the WCD. The editorial author disclosed relationships with several medical device manufacturers.