Kazberuk Małgorzata, Pogorzelski Piotr, Kuźma Łukasz, Kurasz Anna, Róg-Makal Magdalena, Matys Urszula, Tokarewicz Justyna, Kralisz Paweł, Dobrzycki Sławomir
Department of Invasive Cardiology, Medical University of Białystok, 15-089 Białystok, Poland.
J Clin Med. 2024 Dec 17;13(24):7686. doi: 10.3390/jcm13247686.
Sudden cardiac death (SCD) remains a major global health concern and represents one of the most common causes of mortality due to cardiovascular diseases. The wearable cardioverter-defibrillator (WCD) is an innovative, non-invasive medical device designed to provide continuous heart monitoring and immediate defibrillation in patients at risk for SCD. The study aimed to assess the efficacy of WCD usage in patients awaiting decision on therapy with implantable cardioverter-defibrillators (ICDs). We explored the clinical applications, benefits, and limitations of WCD usage within the BIA-VEST registry in Poland over the years 2021-2023. The study included 10 patients with a mean age of 49.1 ± 12.02 years. All patients demonstrated good tolerance and compliance with the LifeVest WCD, wearing it for an average of 93.1 days, about 22.8 h per day (95.7% of the time). No interventions from LifeVests were recorded, and there were no effective, ineffective, or inadequate discharges. After the first follow-up echocardiography, five patients still required ICDs. Due to improved LVEF and overall condition in six out of ten patients undergoing WCD bridge therapy, ICD implantation was finally waived. The WCD acts as a bridge to therapy, such as ICD implantation or cardiac surgery, and may be particularly beneficial for patients with transient or evolving conditions, such as structural heart diseases and life-threatening ventricular arrhythmias.
心源性猝死(SCD)仍然是一个重大的全球健康问题,是心血管疾病导致死亡的最常见原因之一。可穿戴式心脏复律除颤器(WCD)是一种创新的非侵入性医疗设备,旨在为有SCD风险的患者提供持续的心脏监测和即时除颤。该研究旨在评估WCD在等待植入式心脏复律除颤器(ICD)治疗决策的患者中的使用效果。我们在2021年至2023年期间,在波兰的BIA-VEST注册研究中探索了WCD使用的临床应用、益处和局限性。该研究纳入了10名患者,平均年龄为49.1±12.02岁。所有患者对LifeVest WCD均表现出良好的耐受性和依从性,平均佩戴93.1天,每天约22.8小时(占总时间的95.7%)。未记录到LifeVest的干预情况,也没有有效、无效或不适当的放电情况。首次随访超声心动图检查后,仍有5名患者需要植入ICD。由于接受WCD桥接治疗的10名患者中有6名患者的左心室射血分数(LVEF)和整体状况有所改善,最终放弃了ICD植入。WCD可作为ICD植入或心脏手术等治疗的桥梁,对于患有短暂性或进展性疾病(如结构性心脏病和危及生命的室性心律失常)的患者可能特别有益。