Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study
Rodrigue Garcia
(1, 2)
,
Nicolas Combes
(3)
,
Pascal Defaye
(4)
,
Kumar Narayanan
(5, 6, 7)
,
Laurence Guedon-Moreau
(8)
,
Serge Boveda
(3)
,
Hugues Blangy
(9)
,
Jérôme Bouet
(10)
,
Florent Briand
(11)
,
Philippe Chevalier
(12)
,
Yves Cottin
(13)
,
Antoine da Costa
(14)
,
Bruno Degand
(1)
,
Jean-Claude Deharo
(15)
,
Romain Eschalier
(16)
,
Fabrice Extramiana
(17)
,
Marc Goralski
(18)
,
Benoit Guy-Moyat
(19)
,
Yves Guyomar
(20)
,
Jean-Sylvain Hermida
(21)
,
François Jourda
(22)
,
Nicolas Lellouche
(23)
,
Mohanad Mahfoud
(24)
,
Vladimir Manenti
(25)
,
Jacques Mansourati
(26)
,
Angéline Martin
(27)
,
Jean-Luc Pasquié
(28)
,
Philippe Ritter
(29)
,
Anne Rollin
(30)
,
Thierry Tibi
(31)
,
Arab Yalioua
(32)
,
Daniel Gras
(33)
,
Nicolas Sadoul
(9)
,
Olivier Piot
(34)
,
Christophe Leclercq
(35)
,
Eloi Marijon
(5, 6)
1
CHU de Poitiers [La Milétrie] -
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
2 UP - Université de Poitiers = University of Poitiers
3 Clinique Pasteur [Toulouse]
4 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
5 HEGP - Hôpital Européen Georges Pompidou [APHP]
6 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
7 Medicover Hospitals, Hyderabad, India
8 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
9 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
10 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
11 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
12 CHU Lyon - Centre Hospitalier Universitaire de Lyon
13 CHU Dijon
14 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
15 TIMONE - Hôpital de la Timone [CHU - APHM]
16 CHU Clermont-Ferrand
17 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
18 CHRO - Centre Hospitalier Régional d'Orléans
19 CHU Limoges
20 Hôpital Saint Philibert [Lomme]
21 CHU Amiens-Picardie
22 CHA - Centre hospitalier d'Auxerre
23 CHU Henri Mondor [Créteil]
24 Centre Hospitalier Sud Francilien
25 Hôpital Privé Jacques Cartier [Massy]
26 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
27 Centre de convalescence gériatrique de Fontaine
28 CHU Montpellier
29 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
30 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
31 Centre Hospitalier de Cannes
32 CH Angoulême - Centre Hospitalier d'Angoulême
33 Hôpital privé du Confluent [Nantes]
34 CCN - Centre cardiologique du Nord
35 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
2 UP - Université de Poitiers = University of Poitiers
3 Clinique Pasteur [Toulouse]
4 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
5 HEGP - Hôpital Européen Georges Pompidou [APHP]
6 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
7 Medicover Hospitals, Hyderabad, India
8 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
9 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
10 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
11 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
12 CHU Lyon - Centre Hospitalier Universitaire de Lyon
13 CHU Dijon
14 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
15 TIMONE - Hôpital de la Timone [CHU - APHM]
16 CHU Clermont-Ferrand
17 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
18 CHRO - Centre Hospitalier Régional d'Orléans
19 CHU Limoges
20 Hôpital Saint Philibert [Lomme]
21 CHU Amiens-Picardie
22 CHA - Centre hospitalier d'Auxerre
23 CHU Henri Mondor [Créteil]
24 Centre Hospitalier Sud Francilien
25 Hôpital Privé Jacques Cartier [Massy]
26 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
27 Centre de convalescence gériatrique de Fontaine
28 CHU Montpellier
29 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
30 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
31 Centre Hospitalier de Cannes
32 CH Angoulême - Centre Hospitalier d'Angoulême
33 Hôpital privé du Confluent [Nantes]
34 CCN - Centre cardiologique du Nord
35 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Rodrigue Garcia
- Fonction : Auteur
- PersonId : 793281
- ORCID : 0000-0001-9350-2437
Jean-Sylvain Hermida
- Fonction : Auteur
- PersonId : 1151137
- ORCID : 0000-0001-9276-2886
- IdRef : 07600211X
Jacques Mansourati
- Fonction : Auteur
- PersonId : 765861
- ORCID : 0000-0002-6697-7194
Christophe Leclercq
- Fonction : Auteur
- PersonId : 1247903
- ORCID : 0000-0002-4399-5568
Résumé
Abstract 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.