Abstract
Background An implantable cardioverter defibrillator (ICD) is effective in preventing sudden cardiac death (SCD). Once an ICD is removed and reimplantation is not feasible, a wearable cardioverter defibrillator (WCD) may be an alternative option. We determined the effectiveness of WCD for SCD prevention in patients who were discharged after ICD removal. Methods A retrospective study was conducted on all WCD (LifeVest, ZOLL, Pittsburgh, PA, USA) patients who underwent ICD removal due to cardiac device infections (CDIs) at two referral centers between January 1, 2005 and December 31, 2009. Clinical characteristics, device information, and WCD data were analyzed. Sudden cardiac arrest was defined as all sustained ventricular tachycardia (VT) and ventricular fibrillation occurring within a single 24-hour period. Results Ninety-seven patients (mean age 62.8 ± 13.3, male 80.4%) were included in the study. The median duration of antibiotic use was 14.7 days (interquartile range [IQR] 10-30). The median daily WCD use was 20 hours/day and the median length of use was 21 days (IQR 5-47). A total of three patients were shocked by WCD. Two patients had four episodes of sustained VT, successfully terminated by the WCD. A third patient experienced two inappropriate treatments due to oversensitivity of the signal artifact. Three patients experienced sudden death outside the hospital while not wearing the device. Five patients died while hospitalized. Conclusion WCD can prevent SCD, until ICD reimplantation is feasible in patients who underwent device removals for CDI. However, patient compliance is essential for the effective use of this device.
| Original language | English |
|---|---|
| Pages (from-to) | 562-568 |
| Number of pages | 7 |
| Journal | PACE - Pacing and Clinical Electrophysiology |
| Volume | 37 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 2014 |
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Keywords
- ICD removal
- sudden cardiac death
- wearable cardioverter defibrillator
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Protection from outpatient sudden cardiac death following ICD removal using a wearable cardioverter defibrillator. / Tanawuttiwat, Tanyanan; Garisto, Juan D.; Salow, Arturo; Glad, Joann M.; Szymkiewicz, Steve; Saltzman, Heath E.; Kutalek, Steven P.; Carrillo, Roger.
In: PACE - Pacing and Clinical Electrophysiology, Vol. 37, No. 5, 01.01.2014, p. 562-568.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Protection from outpatient sudden cardiac death following ICD removal using a wearable cardioverter defibrillator
AU - Tanawuttiwat, Tanyanan
AU - Garisto, Juan D.
AU - Salow, Arturo
AU - Glad, Joann M.
AU - Szymkiewicz, Steve
AU - Saltzman, Heath E.
AU - Kutalek, Steven P.
AU - Carrillo, Roger
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Background An implantable cardioverter defibrillator (ICD) is effective in preventing sudden cardiac death (SCD). Once an ICD is removed and reimplantation is not feasible, a wearable cardioverter defibrillator (WCD) may be an alternative option. We determined the effectiveness of WCD for SCD prevention in patients who were discharged after ICD removal. Methods A retrospective study was conducted on all WCD (LifeVest, ZOLL, Pittsburgh, PA, USA) patients who underwent ICD removal due to cardiac device infections (CDIs) at two referral centers between January 1, 2005 and December 31, 2009. Clinical characteristics, device information, and WCD data were analyzed. Sudden cardiac arrest was defined as all sustained ventricular tachycardia (VT) and ventricular fibrillation occurring within a single 24-hour period. Results Ninety-seven patients (mean age 62.8 ± 13.3, male 80.4%) were included in the study. The median duration of antibiotic use was 14.7 days (interquartile range [IQR] 10-30). The median daily WCD use was 20 hours/day and the median length of use was 21 days (IQR 5-47). A total of three patients were shocked by WCD. Two patients had four episodes of sustained VT, successfully terminated by the WCD. A third patient experienced two inappropriate treatments due to oversensitivity of the signal artifact. Three patients experienced sudden death outside the hospital while not wearing the device. Five patients died while hospitalized. Conclusion WCD can prevent SCD, until ICD reimplantation is feasible in patients who underwent device removals for CDI. However, patient compliance is essential for the effective use of this device.
AB - Background An implantable cardioverter defibrillator (ICD) is effective in preventing sudden cardiac death (SCD). Once an ICD is removed and reimplantation is not feasible, a wearable cardioverter defibrillator (WCD) may be an alternative option. We determined the effectiveness of WCD for SCD prevention in patients who were discharged after ICD removal. Methods A retrospective study was conducted on all WCD (LifeVest, ZOLL, Pittsburgh, PA, USA) patients who underwent ICD removal due to cardiac device infections (CDIs) at two referral centers between January 1, 2005 and December 31, 2009. Clinical characteristics, device information, and WCD data were analyzed. Sudden cardiac arrest was defined as all sustained ventricular tachycardia (VT) and ventricular fibrillation occurring within a single 24-hour period. Results Ninety-seven patients (mean age 62.8 ± 13.3, male 80.4%) were included in the study. The median duration of antibiotic use was 14.7 days (interquartile range [IQR] 10-30). The median daily WCD use was 20 hours/day and the median length of use was 21 days (IQR 5-47). A total of three patients were shocked by WCD. Two patients had four episodes of sustained VT, successfully terminated by the WCD. A third patient experienced two inappropriate treatments due to oversensitivity of the signal artifact. Three patients experienced sudden death outside the hospital while not wearing the device. Five patients died while hospitalized. Conclusion WCD can prevent SCD, until ICD reimplantation is feasible in patients who underwent device removals for CDI. However, patient compliance is essential for the effective use of this device.
KW - ICD removal
KW - sudden cardiac death
KW - wearable cardioverter defibrillator
UR - http://www.scopus.com/inward/record.url?scp=84899658950&partnerID=8YFLogxK
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U2 - 10.1111/pace.12319
DO - 10.1111/pace.12319
M3 - Article
VL - 37
SP - 562
EP - 568
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
SN - 0147-8389
IS - 5
ER -