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

Tanja Odeneg, Christian Ebner, Deddo Mörtl, Hans Keller, Alfred Dirninger, Günter Stix, Bernhard Föger, Georg Grimm, Clemens Steinwender, Franz Gebetsberger, Markus Stühlinger, Bernadette Mastnak, Christian Haider, Martin Manninger, Daniel Scherr

Research output: Journal article (peer-reviewed)Journal article

11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)75-83
Number of pages9
JournalEuropean Journal of Cardiovascular Nursing
Volume18
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac/therapy
  • Austria
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance/psychology
  • Patient Education as Topic/statistics & numerical data
  • Registries
  • Time Factors
  • Treatment Outcome
  • Wearable Electronic Devices/psychology

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