Cited by 297Cardiac pacing and defibrillation studiesCardiac Arrest and ResuscitationCardiac electrophysiology and arrhythmias

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Aggregate National Experience With the Wearable Cardioverter-Defibrillator

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Chung, Mina K., Szymkiewicz, Steven J., Shao, Mingyuan, Zishiri, Edwin, Niebauer, Mark J., Lindsay, Bruce D., Tchou, Patrick J.·2010·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2010.04.016PMC PMC2962668

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Abstract

Objectives The purpose of this study was to determine patient compliance and effectiveness of antiarrhythmic treatment by the wearable cardioverter-defibrillator (WCD).Background Effectiveness of the WCD for prevention of sudden death is dependent on event type, patient compliance, and appropriate management of ventricular tachycardia/ventricular fibrillation (VT/VF).Methods Compliance and events were recorded in a nationwide registry of post-market release WCDs. Survival, using the Social Security Death Index, was compared with survival in implantable cardioverter-defibrillator (ICD) patients.Results Of 3,569 patients wearing the WCD (age 59.3+/-14.7 years, duration 52.6+/-69.9 days), daily use was 19.9+/-4.7 h (>90% of the day) in 52% of patients. More days of use correlated with higher daily use (p<0.001). Eighty sustained VT/VF events occurred in 59 patients (1.7%). First-shock success was 76 of 76 (100%) for unconscious VT/VF and 79 of 80 (99%) for all VT/VF. Eight patients died after successful conversion of unconscious VT/VF (89.5% survival of VT/VF events). Asystole occurred in 23 (17 died), pulseless electrical activity in 2, and respiratory arrest in 1 (3 died), representing 24.5% of sudden cardiac arrests. During WCD use, 3,541 of 3,569 patients (99.2%) survived overall. Survival occurred in 72 of 80 (90%) VT/VF events and 78 of 106 (73.6%) for all events. Long-term mortality was not significantly different from first ICD implant patients but highest among patients with traditional ICD indications.Conclusions Compliance was satisfactory with 90% wear time in >50% of patients and low sudden death mortality during use. Survival was comparable to that of ICD patients. However, asystole was an important cause of mortality in sudden cardiac arrest events.

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Authors: Chung, M. K., Szymkiewicz, S. J., Shao, M., Zishiri, E., Niebauer, M. J., Lindsay, B. D., & Tchou, P. J.
Affiliations: Cleveland Clinic (US)
ZOLL Medical Corporation (United States) (US)
Corresponding author: Chung, Mina K.
ORCID: Chung, Mina K.
Szymkiewicz, Steven J.
Shao, Mingyuan
Zishiri, Edwin
Niebauer, Mark J.
Tchou, Patrick J.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2010-07
Volume: 56
Issue: 3
Pages: 194-203
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2010.04.016
PMC: PMC2962668
OpenAlex: W2159588890
Cited by: 297
References: 16
Citations by year: 2026: 5 · 2025: 6 · 2024: 9 · 2023: 15 · 2022: 11 · 2021: 19 · 2020: 26 · 2019: 21 · 2018: 28 · 2017: 33 · 2016: 39 · 2015: 20 · 2014: 14 · 2013: 19 · 2012: 13
FWCI: 10.98
Type: journal article
Language: en
Update notices: erratum (2011-01-11)
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1111 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Medtronic, Inc.
Boston Scientific
St. Jude Medical
Biotronik
Medtronic
National Institutes of Health (NIH R01 HL090620)
ZOLL
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: wearable cardioverter defibrillator, medication adherence, sudden cardiac death prevention, ventricular tachycardia, ventricular fibrillation, implantable cardioverter-defibrillator, survival, asystole, sudden cardiac arrest, post-market registry
MeSH terms: Female, Humans, Male, Middle Aged, Patient Compliance, Ventricular Fibrillation, Death, Sudden, Cardiac, Tachycardia, Ventricular, Defibrillators

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Aggregate National Experience With the Wearable Cardioverter-Defibrillator

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