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2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).2015年欧洲心脏病学会(ESC)室性心律失常患者管理和心脏性猝死预防指南:欧洲心脏病学会(ESC)室性心律失常患者管理和心脏性猝死预防工作组得到欧洲儿科和先天性心脏病学会(AEPC)认可。
Europace. 2015 Nov;17(11):1601-87. doi: 10.1093/europace/euv319. Epub 2015 Aug 29.
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Use of the wearable cardioverter defibrillator in high-risk cardiac patients: data from the Prospective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry).可穿戴式心脏除颤器在高危心脏患者中的应用:来自前瞻性可穿戴式心脏除颤器(WEARIT-II 注册研究)患者使用登记数据库的数据。
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Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post-myocardial infarction.穿戴式心脏除颤器在心肌梗死后早期被认为高危患者中的应用。
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Risk stratification for implantable cardioverter defibrillator therapy: the role of the wearable cardioverter-defibrillator.植入式心脏复律除颤器治疗的风险分层:可穿戴式心脏除颤器的作用。
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Early risk of mortality after coronary artery revascularization in patients with left ventricular dysfunction and potential role of the wearable cardioverter defibrillator.左心室功能障碍患者冠状动脉血运重建术后的早期死亡率风险及可穿戴式除颤器的潜在作用。
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The natural history of new-onset heart failure with a severely depressed left ventricular ejection fraction: implications for timing of implantable cardioverter-defibrillator implantation.新发心力衰竭伴严重左心室射血分数降低患者的自然病史:对植入式心脏复律除颤器植入时机的影响。
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Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival.可穿戴式除颤器的综合国家经验:事件发生率、依从性和生存率。
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可穿戴式心脏复律除颤器在心脏性猝死高危患者中的应用经验

Experience With the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death.

作者信息

Wäßnig Nadine K, Günther Michael, Quick Silvio, Pfluecke Christian, Rottstädt Fabian, Szymkiewicz Steven J, Ringquist Steven, Strasser Ruth H, Speiser Uwe

机构信息

From Technische Universität Dresden, Heart Center Dresden, University Hospital, Department of Internal Medicine and Cardiology, Dresden, Germany (N.W., M.G., S.Q., C.P., F.R., R.S., U.S.); and ZOLL, Pittsburgh, PA (S.S., S.R.).

出版信息

Circulation. 2016 Aug 30;134(9):635-43. doi: 10.1161/CIRCULATIONAHA.115.019124. Epub 2016 Jul 25.

DOI:10.1161/CIRCULATIONAHA.115.019124
PMID:27458236
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4998124/
Abstract

BACKGROUND

This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation.

METHODS

From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers. Deidentified German patient data were used for a retrospective, nonrandomized analysis.

RESULTS

Ninety-four patients (1.6%) were treated by the WCD in response to ventricular tachyarrhythmia/fibrillation. The incidence rate was 8.4 (95% confidence interval, 6.8-10.2) per 100 patient-years. Patients with implantable cardioverter-defibrillator explantation had an incidence rate of 19.3 (95% confidence interval, 12.2-29.0) per 100 patient-years. In contrast, an incidence rate of 8.2 (95% confidence interval, 6.4-10.3) was observed in the remaining cardiac diagnosis groups, including dilated cardiomyopathy, myocarditis, and ischemic and nonischemic cardiomyopathies. Among 120 shocked patients, 112 (93%) survived 24 hours after treatment, whereas asystole was observed in 2 patients (0.03%) with 1 resulting death.

CONCLUSIONS

This large cohort represents the first nationwide evaluation of WCD use in patients outside the US healthcare system and confirms the overall value of the WCD in German treatment pathways.

摘要

背景

本研究评估了可穿戴式心脏复律除颤器(WCD)在预防室性快速心律失常或颤动所致猝死方面的使用情况及有效性。

方法

从2010年4月至2013年10月,从德国404个中心招募了6043例德国WCD患者(中位年龄57岁;男性占78.5%)。使用经过去识别处理的德国患者数据进行回顾性非随机分析。

结果

94例患者(1.6%)接受了WCD针对室性快速心律失常/颤动的治疗。发病率为每100患者年8.4例(95%置信区间为6.8 - 10.2)。植入式心脏复律除颤器被移除的患者发病率为每100患者年19.3例(95%置信区间为12.2 - 29.0)。相比之下,在包括扩张型心肌病、心肌炎以及缺血性和非缺血性心肌病在内的其余心脏诊断组中,观察到的发病率为每100患者年8.2例(95%置信区间为6.4 - 10.3)。在120例接受电击治疗的患者中,112例(93%)在治疗后存活24小时,而2例患者(0.03%)出现心脏停搏,其中1例死亡。

结论

这个大型队列代表了对美国医疗系统以外患者使用WCD的首次全国性评估,并证实了WCD在德国治疗途径中的总体价值。