比较穿戴式心脏除颤器（WCD）保护患者的结果，（WCD）佩戴时间<90 天和≥90 天。
Comparison of the Outcome of Patients Protected by the Wearable Cardioverter Defibrillator (WCD) for <90 Wear Days ≥90 Wear Days.
机构信息
First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
出版信息
In Vivo. 2020 Nov-Dec;34(6):3601-3610. doi: 10.21873/invivo.12205.
BACKGROUND/AIM: The wearable cardioverter/defibrillator (WCD) is recommended to prevent sudden cardiac death (SCD). Guidelines suggest a 90 days' period, but prolongation of WCD wear time until increasing the ejection fraction (≥35%) might be suggested.
PATIENTS AND METHODS
A cohort of 153 patients with prescribed WCD were divided into two groups: A <90 wear days' group (n=112) vs. ≥90 wear days' group (n=41) and followed.
RESULTS
In the first group, WCD shock occurred in 3.6% of patients, 47.3% improved in left ventricular ejection fraction (LVEF) after 3 months, and 37.5% had a cardiac implantable electronic device (CIED) implantation with appropriate implantable cardioverter defibrillator (ICD) shock events occurring in 6 patients. Two of these patients already received WCD shock therapy due to ventricular fibrillation. A 20.5% improved in LVEF after 6-12 months, but 73% were already implanted with ICD. In the second group, 4.9% received WCD shock, 34.1% improved in LVEF after 3 months, 48.8% were implanted with ICD, and 2 had ICD shocks during follow up time. LVEF improvement after 6-12 months occurred in 26.8%. ICD implantation was prevented in 7.3% of patients due to LVEF recovery.
CONCLUSION
Prolonging wearing days of WCD may reduce the number of inappropriate ICD implantation.
背景/目的：可穿戴式心脏除颤器（WCD）被推荐用于预防心源性猝死（SCD）。指南建议佩戴 90 天，但如果延长 WCD 佩戴时间直至射血分数增加（≥35%），可能会建议延长佩戴时间。
患者和方法
一组 153 名被处方 WCD 的患者被分为两组：<90 天佩戴组（n=112）与≥90 天佩戴组（n=41）并进行随访。
结果
在第一组中，3.6%的患者发生了 WCD 电击，47.3%的患者在 3 个月后左心室射血分数（LVEF）改善，37.5%的患者植入了心脏植入式电子设备（CIED），其中 6 名患者发生了适当的植入式心律转复除颤器（ICD）电击事件。其中 2 名患者已经因为室颤接受了 WCD 电击治疗。6-12 个月后 LVEF 改善了 20.5%，但 73%的患者已经植入了 ICD。在第二组中，4.9%的患者发生了 WCD 电击，34.1%的患者在 3 个月后 LVEF 改善，48.8%的患者植入了 ICD，并且在随访期间有 2 名患者发生了 ICD 电击。6-12 个月后 LVEF 改善了 26.8%。由于 LVEF 恢复，有 7.3%的患者避免了 ICD 植入。
结论
延长 WCD 的佩戴时间可能会减少不适当 ICD 植入的数量。
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