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Article Dans Une Revue EP-Europace Année : 2020

Wearable cardioverter-defibrillator in patients with a transient risk of Sudden cardiac death: the WEARIT-France cohort study

Rodrigue Garcia
Nicolas Combes
Pascal Defaye
Kumar Narayanan
  • Fonction : Auteur
Laurence Guedon-Moreau
  • Fonction : Auteur
Serge Boveda
Hugues Blangy
  • Fonction : Auteur
Jérôme Bouet
  • Fonction : Auteur
Florent Briand
  • Fonction : Auteur
Philippe Chevalier
  • Fonction : Auteur
Yves Cottin
Antoine da Costa
Bruno Degand
  • Fonction : Auteur
Romain Eschalier
Marc Goralski
  • Fonction : Auteur
Benoit Guy-Moyat
  • Fonction : Auteur
Yves Guyomar
  • Fonction : Auteur
Jean-Sylvain Hermida
François Jourda
  • Fonction : Auteur
Nicolas Lellouche
  • Fonction : Auteur
  • PersonId : 764872
  • IdRef : 075154625
Mohanad Mahfoud
  • Fonction : Auteur
Vladimir Manenti
  • Fonction : Auteur
Jacques Mansourati
Angéline Martin
  • Fonction : Auteur
Philippe Ritter
  • Fonction : Auteur
Anne Rollin
  • Fonction : Auteur
Thierry Tibi
  • Fonction : Auteur
Arab Yalioua
  • Fonction : Auteur
Daniel Gras
  • Fonction : Auteur
Nicolas Sadoul
  • Fonction : Auteur
Olivier Piot
Christophe Leclercq
Eloi Marijon

Résumé

Aims : We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability.Methods and results : Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services. Overall, 1157 patients were included (mean age 60 ± 12 years, 16% women; 46% prospectively): 82.1% with ischaemic cardiomyopathy, 10.3% after implantable cardioverter-defibrillator explant, and 7.6% before heart transplantation. Median WCD usage period was 62 (37-97) days. Median daily wear time of WCD was 23.4 (22.2-23.8) h. In multivariate analysis, younger age was associated with lower compliance [adjusted odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95-0.99, P < 0.01]. A total of 18 participants (1.6%) received at least one appropriate shock, giving an incidence of appropriate therapy of 7.2 per 100 patient-years. Patient-response button allowed the shock to be aborted in 35.7% of well-tolerated sustained ventricular arrhythmias and in 95.4% of inappropriate ventricular arrhythmia detection, finally resulting in an inappropriate therapy in eight patients (0.7%).Conclusion: Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients. Moreover, they emphasize the fact that when prescribed appropriately, in concert with adequate patient education and dedicated follow-up using specific remote monitoring system, compliance with WCD is high and the device well-tolerated by the patient.
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Origine : Publication financée par une institution

Dates et versions

hal-03037854 , version 1 (05-01-2021)

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Citer

Rodrigue Garcia, Nicolas Combes, Pascal Defaye, Kumar Narayanan, Laurence Guedon-Moreau, et al.. Wearable cardioverter-defibrillator in patients with a transient risk of Sudden cardiac death: the WEARIT-France cohort study. EP-Europace, 2020, ⟨10.1093/europace/euaa268⟩. ⟨hal-03037854⟩
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