Ventricular Arrhythmia Occurrence and Compliance in Patients Treated With the Wearable Cardioverter Defibrillator Following Percutaneous Coronary Intervention

Barraud, Jérémie; Pinon, Pauline; Laine, Marc; Cautela, Jennifer; Orabona, Morgane; Koutbi, Linda; Pinto, Johan; Thuny, Franck; Franceschi, Frédéric; Paganelli, Franck; Bonello, Laurent; Peyrol, Michaël

doi:10.1016/j.hlc.2017.08.022

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…After addition of two citations identified by hand search, forty-six primary studies, two systematic reviews, and one HTA were included for final analysis (see Figure 1). The forty-six primary studies included one RCT 7, one nrCT (11), sixteen non-comparative prospective trials (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), and twenty-eight non-comparative retrospective trials (4;28-54). The RCT showed a low and the nrCT a high risk of bias.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness, efficacy, and safety of wearable cardioverter-defibrillators in the treatment of sudden cardiac arrest – Results from a health technology assessment

Aidelsburger¹,

Seyed-Ghaemi²,

Guinin³

et al. 2020

Int J Technol Assess Health Care

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Objectives To assess the effectiveness, efficacy, and safety of a wearable cardioverter-defibrillator (WCD) in adult persons with high risk for sudden cardiac arrest and for which an implantable cardioverter is currently not applicable. Methods We performed a systematic literature search in Medline, Embase, Cochrane Library, and CRD-databases. Study selection was performed by two reviewers independently. Data were presented quantitatively; due to heterogeneity of studies no meta-analysis was performed. Results One randomized-controlled trial (RCT), one non-randomized comparative trial, and forty-four non-comparative trials were included. The RCT reported an overall mortality of 3.1 percent in the WCD group versus 4.9 percent in controls (relative risk [RR]: .64; 95 percent confidence interval [CI], .43–.98, p = .04), but no significant effect on arrhythmia-related mortality. The RR for arrhythmia-related mortality amounted to .67 (95 percent CI, .37–1.21, p = .18) as assessed in the RCT. Appropriate shocks were observed in 1.3 percent of patients in both comparative studies, and inappropriate shocks in .6 percent of patients in the RCT. Termination of ventricular tachycardia (VT) or ventricular fibrillation (VF) was successful in 75 to 100 percent of appropriate shocks in all studies. Adverse events assessed in the RCT showed a lower incidence of shortness of breath (38.8 percent vs. 45.3 percent; p = .004), higher incidence of rash at any location (15.3 percent vs. 7.1 percent; p < .001), and higher incidence of itching at any location (17.2 percent vs. 6.4 percent; p < .001) for WCD. Conclusions Available evidence demonstrates that the WCD detects and terminates VT/VF events reliably and shows a high rate of appropriate shocks in mixed patient populations. Data of large registries confirm that the WCD is a safe intervention.

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Section: Resultsmentioning

confidence: 99%

Effectiveness, efficacy, and safety of wearable cardioverter-defibrillators in the treatment of sudden cardiac arrest – Results from a health technology assessment

Aidelsburger¹,

Seyed-Ghaemi²,

Guinin³

et al. 2020

Int J Technol Assess Health Care

View full text Add to dashboard Cite

show abstract

“…Overall, 5 publications focused on post-MI patients [5,15,38,41,49], 5 on ICD explanted patients [20,21,37,47,56] and the other 45 publications involved subjects with mixed diagnoses.…”

Section: Possible and Potential Indications For Wcd Usementioning

confidence: 99%

“…In total, 26 original researches were found, of which 4 focus on patients with MI [5,15,38,49] and 3 focus on those with ICD explant [20,21,47], while 19 (73%) studies evaluated the use of the WCD across various indications, specified as "mixed" [7,8,11,17,18 [32] and 1 in Israel [17]. No study was performed in, or included data from Italy.…”

Section: Effectiveness Safety and Compliance Of Wcd In Patients With MI Or With Icd Explantmentioning

confidence: 99%

“…Generally, all these studies covered aspects on effectiveness and/or safety and/or compliance and/or on optimization of WCD use in different indications and contexts. Eighteen studies were retrospective [7,8,18,20,21,25,27,32,36,38,42,47,49,50,[51][52][53][54], and 7 studies were prospective [11,15,17,22,30,39,57]. One study was a multicenter, randomized, controlled trial where eligible participants with a previous MI were randomly assigned in a 2:1 ratio to receive a WCD plus guideline-directed medical therapy (the device group) or to receive guideline directed medical therapy alone (the control group), at hospital discharge [5].…”

Section: Effectiveness Safety and Compliance Of Wcd In Patients With MI Or With Icd Explantmentioning

confidence: 99%

“…Based on this analysis, the VEST trial reported a total mortality rate of 0.50 per 100 person-months of patients wearing the device, and 1.91 per 100 person-months of patients not wearing the device, reporting a higher efficacy of VEST (rate ratio = 0.26; 95% CI = 0.14-0.48; Bonferroni corrected p<0.001). A study conducted in France [15], reported that WCD was life-saving in one patient (1/24) with prompt defibrillation shock delivery. During a mean wearing period of 3.0 ± 1.3 months, two episodes of VA occurred in two patients (8.3%): one successfully treated with WCD shock and one with spontaneous termination.…”

Section: Effectiveness Safety and Compliance Of Wcd In Patients With MI Or With Icd Explantmentioning

confidence: 99%

See 2 more Smart Citations

Health Technology Assessment on the use of the Wearable Cardioverter Defibrillator in Patients with Myocardial Infarction and with ICD Explant

Cortesi

Botto²,

D’Angiolella

et al. 2021

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Defibrillatorweste

Duncker

Veltmann

2018

Herzschr Elektrophys

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Defibrillatorweste Aktueller Stand Der plötzliche Herztod zählt zu den häufigsten Todesursachen, meist infolge ventrikulärer Tachyarrhythmien. Zum Schutz vor dem plötzlichen Herztod ist die Therapie mit implantierbaren Kardioverter-Defibrillatoren (ICD) bei Patienten mit einem dauerhaft erhöhten Risiko etabliert. Für Patienten mit einem (noch) unbekannten oder möglicherweise temporären Risiko für den plötzlichen Herztod ist seit einigen Jahren eine Defibrillatorweste ("wearable cardioverterdefibrillator", WCD) zur Vermeidung eines plötzlichen Arrhythmie-bedingten Todes verfügbar. Insofern ist der WCD nicht als Alternative, sondern als Ergänzung der ICD-Therapie zur Vermeidung des plötzlichen Herztodes zu sehen. Abb. 1 8 Defibrillatorweste. (Mit freundl. Genehmigung von Zoll CMS GmbH)

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Ventricular Arrhythmia Occurrence and Compliance in Patients Treated With the Wearable Cardioverter Defibrillator Following Percutaneous Coronary Intervention

Cited by 8 publications

References 19 publications

Effectiveness, efficacy, and safety of wearable cardioverter-defibrillators in the treatment of sudden cardiac arrest – Results from a health technology assessment

Effectiveness, efficacy, and safety of wearable cardioverter-defibrillators in the treatment of sudden cardiac arrest – Results from a health technology assessment

Health Technology Assessment on the use of the Wearable Cardioverter Defibrillator in Patients with Myocardial Infarction and with ICD Explant

Defibrillatorweste

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