The Wearable Cardioverter Defibrillator in Nonischemic Cardiomyopathy: A US National Database Analysis

Negar Salehi, Mojdeh Nasiri, Nicole R. Bianco, Madalina Opreanu, Vini Singh, Vaibhav Satija, Aravdeep S. Jhand, Lilit Karapetyan, Abdul Rahman Safadi, Phani Surapaneni, Ranjan K. Thakur

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background The wearable cardioverter defibrillator (WCD) is often used in patients at risk of sudden cardiac death (SCD) who are not yet candidates for an implantable cardioverter defibrillator (ICD). Newly diagnosed cardiomyopathy may be reversible, and a WCD may protect patients during the initial period of risk. We evaluate the benefit and compliance of the WCD in patients with nonischemic cardiomyopathy (NICM). Methods We reviewed a national database of patients with NICM who used WCDs and who self-reported a history of excess alcohol use, although other causes of cardiomyopathy could not be excluded. The database contained demographic data, initial ejection fraction (EF), reason for WCD prescription, compliance and use data, any detected arrhythmias, therapies, and reason for discontinuing WCD. Statistical analyses were performed using SAS, version 9.3 (SAS Institute, Cary, NC). Results Of the 127 patients, 88% were men with a mean age of 52.6 ± 11.0 years. The mean initial EF was 19.9% ± 7.4%. Patients wore the WCD for a median of 51 days and a median daily use of 18.0 hours per day. The most common reasons for discontinuing the WCD were improvement in EF (33%) or ICD implantation (23.6%). Seven patients (5.5%) had 9 sustained ventricular arrhythmia events, which were successfully treated with 100% conversion. There were 11 deaths (8.6%) during 100 days of follow-up. No deaths resulted from WCD shock failure or undersensing. Conclusions NICM may have a significant risk of ventricular arrhythmias and death in the first few months. The WCD delivered appropriate therapy in 5.5% of patients. This study suggests that a WCD may be effective temporary prophylaxis for prevention of SCD in patients with newly diagnosed NICM.

Original languageEnglish
Pages (from-to)1247.e1-1247.e6
JournalCanadian Journal of Cardiology
Volume32
Issue number10
DOIs
StatePublished - 1 Oct 2016
Externally publishedYes

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