Indications for and outcome in patients with the wearable cardioverter-defibrillator in a nurse-based training programme: results of the Austrian WCD Registry

被引：25

作者：

Odeneg, Tanja ^{[1
]}

Ebner, Christian ^{[2
]}

Moertl, Deddo ^{[3
]}

Keller, Hans ^{[4
]}

Dirninger, Alfred ^{[5
]}

Stix, Guenter ^{[6
]}

Foeger, Bernhard ^{[7
]}

Grimm, Georg ^{[8
]}

Steinwender, Clemens ^{[9
,10
]}

Gebetsberger, Franz ^{[11
]}

Stuehlinger, Markus ^{[12
]}

Mastnak, Bernadette ^{[1
]}

Haider, Christian ^{[1
]}

Manninger, Martin ^{[1
]}

Scherr, Daniel ^{[1
,13
]}

机构：

[1] Med Univ Graz, Dept Cardiol, Auenbruggerpl 15, A-8036 Graz, Austria

[2] Elisabethinen Hosp Linz, Dept Cardiol, Linz, Austria

[3] Univ Hosp St Poelten, Dept Med, St Polten, Austria

[4] Rudolfstifung Vienna, Dept Med, Vienna, Austria

[5] Hosp Hochsteiermark, Dept Med, Leoben, Austria

[6] Med Univ Vienna, Dept Cardiol, Vienna, Austria

[7] Hosp Bregenz, Dept Med, Bregenz, Austria

[8] Hosp Klagenfurt, Dept Med & Cardiol, Klagenfurt, Austria

[9] Kepler Univ Hosp Linz, Dept Cardiol, Linz, Austria

[10] Paracelsus Med Univ Salzburg, Salzburg, Austria

[11] Hosp Steyr, Dept Med, Steyr, Austria

[12] Med Univ Innsbruck, Med, Innsbruck, Austria

[13] Maastricht Univ, Med Ctr, Dept Cardiol, Cardiovasc Res Inst Maastricht CARIM, Maastricht, Netherlands

来源：

EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING | 2019年 / 18卷 / 01期

关键词：

Wearable defibrillator; sudden cardiac death; arrhythmia; Lifevest; ICD; LEFT-VENTRICULAR DYSFUNCTION; ESC GUIDELINES; EUROPEAN-SOCIETY; TASK-FORCE; HIGH-RISK; EXPERIENCE; ASSOCIATION; MORTALITY; TRIAL; RATES;

D O I：

10.1177/1474515118790365

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：75 / 83

页数：9

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