Barraud Jérémie, Pinon Pauline, Laine Marc, Cautela Jennifer, Orabona Morgane, Koutbi Linda, Pinto Johan, Thuny Franck, Franceschi Frederic, Paganelli Franck, Bonello Laurent, Peyrol Michaël
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Department of Cardiology, Nord Hospital, France; Mediterranean Academic Association for Research and Studies in Cardiology (MARS Cardio), France.
Aix-Marseille University, Assistance Publique - Hôpitaux de Marseille (AP-HM), Department of Cardiology, Hôpital Timone, Marseille, France.
Heart Lung Circ. 2018 Aug;27(8):984-988. doi: 10.1016/j.hlc.2017.08.022. Epub 2017 Sep 25.
The wearable cardioverter defibrillator (WCD) is a life-saving therapy in patients with high risk of arrhythmic death. We aimed to evaluate ventricular arrhythmia (VA) occurrence rate and compliance with the WCD during the first 90 days following myocardial revascularisation with percutaneous coronary intervention (PCI) in patients with left ventricular ejection fraction (LVEF) <30%.
From September 2015 to November 2016, clinical characteristics, WCD recordings and compliance data of the aforementioned subset of patients were prospectively collected.
Twenty-four patients (men=20, 80%) were included in this analysis. Mean age was 56±10 years and mean LVEF at enrolment was 26.6±4.3%. During a mean wearing period of 3.0±1.3 months, two episodes of VA occurred in two patients (8.3%): one successfully treated with WCD shock and one with spontaneous termination. The mean and median daily use of the WCD was 21.5hours and 23.5hours a day, respectively. Eighteen patients (75%) wore the WCD more than 22hours a day.
The rate of VA, during the WCD period use after myocardial revascularisation with PCI, was high in our study. Otherwise it underlined that patient compliance is critical during the WCD period use. Remote monitoring and patient education are keys to achieve good compliance.
可穿戴式心脏复律除颤器(WCD)是对有心律失常死亡高风险患者的一种挽救生命的治疗方法。我们旨在评估左心室射血分数(LVEF)<30%的患者经皮冠状动脉介入治疗(PCI)进行心肌血运重建后的前90天内心室心律失常(VA)的发生率以及对WCD的依从性。
2015年9月至2016年11月,前瞻性收集上述患者亚组的临床特征、WCD记录和依从性数据。
本分析纳入了24例患者(男性20例,占80%)。平均年龄为56±10岁,入组时平均LVEF为26.6±4.3%。在平均佩戴3.0±1.3个月期间,两名患者发生了2次VA发作(8.3%):1次经WCD电击成功治疗,1次自发终止。WCD的平均每日使用时间和中位数分别为每天21.5小时和23.5小时。18例患者(75%)每天佩戴WCD超过22小时。
在我们的研究中,PCI心肌血运重建后使用WCD期间VA的发生率较高。此外,这也强调了在WCD使用期间患者的依从性至关重要。远程监测和患者教育是实现良好依从性的关键。