Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival.
Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival.
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DOI：
10.1016/j.jacc.2010.04.016
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发表时间：
2010-07-13
影响因子：
24
通讯作者：
Tchou, Patrick J.
中科院分区：
文献类型：
--
作者：
Chung, Mina K.;Szymkiewicz, Steven J.;Shao, Mingyuan;Zishiri, Edwin;Niebauer, Mark J.;Lindsay, Bruce D.;Tchou, Patrick J.
目的：探讨穿戴式心律转复除颤器（WCD）对患者抗心律失常治疗的依从性和有效性。WCD预防猝死的有效性取决于事件类型、患者依从性和室性心动过速/颤动（VT/VF）的适当管理。合规和事件记录在上市后wcd的全国注册表中。生存率，使用社会安全死亡指数，与植入式心律转复除颤器（ICD）患者的生存率进行比较。在3569例佩戴WCD的患者（年龄59.3±14.7岁，持续时间52.6±69.9天）中，52%的患者每天使用19.9±4.7小时（每天90%的时间）。使用时间越长，每日使用次数越高（p<0.001）。59例患者（1.7%）发生80例持续性VT/VF事件。无意识VT/VF的首次电击成功率为76/76(100%)，所有VT/VF的首次电击成功率为79/80（99%）。8例患者在成功转换无意识VT/VF后死亡（VT/VF事件生存率为89.5%）。23例发生心脏骤停（17例死亡），2例发生无脉性电活动，1例发生呼吸骤停（3例死亡），占心脏骤停的24.5%。在使用WCD期间，3541/3569例患者（99.2%）总体存活。VT/VF事件的生存率为72/80(90%)，所有事件的生存率为78/106（73.6%）。长期死亡率与首次ICD植入患者无显著差异，但在传统ICD适应症患者中最高。依从性令人满意，患者佩戴时间达90%，50%，使用期间猝死死亡率低。生存率与植入式ICD患者相当。然而，心脏骤停是导致死亡的重要原因。
To determine patient compliance and effectiveness of antiarrhythmic treatment by the wearable cardioverter-defibrillator (WCD). Effectiveness of the WCD for prevention of sudden death is dependent on event type, patient compliance and appropriate management of ventricular tachycardia/fibrillation (VT/VF). Compliance and events were recorded in a nation-wide registry of post-market release WCDs. Survival, using the Social Security Death Index, was compared with survival in implantable cardioverter-defibrillator (ICD) patients. Of 3569 patients wearing the WCD (age 59.3±14.7, duration 52.6±69.9 days), daily use was 19.9±4.7 hours (>90% of the day) in 52% of patients. More days of use correlated with higher daily use (p<0.001). Eighty sustained VT/VF events occurred in 59 patients (1.7%). First shock success was 76/76 (100%) for unconscious VT/VF and 79/80 (99%) for all VT/VF. Eight patients died after successful conversion of unconscious VT/VF (survival 89.5% of VT/VF events). Asystole occurred in 23 (17 died), pulseless electrical activity in 2 and respiratory arrest in 1 (3 died), representing 24.5% of sudden cardiac arrests. During WCD use, 3541/3569 patients (99.2%) survived overall. Survival occurred in 72/80 (90%) VT/VF events and 78/106 (73.6%) for all events. Long-term mortality was not significantly different from first ICD implant patients but highest among patients with traditional ICD indications. Compliance was satisfactory with 90% wear time in >50% of patients and low sudden death mortality during usage. Survival was comparable to that of implantable ICD patients. However, asystole was an important cause of mortality in sudden cardiac arrest events.
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影响因子：
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作者：
Ho, P. Michael;Spertus, John A.;Rumsfeld, John S.
通讯作者：
Rumsfeld, John S.
影响因子：
158.5
作者：
Hohnloser, SH;Kuck, KH;Connolly, SJ
通讯作者：
Connolly, SJ
影响因子：
37.8
作者：
Bokhari, F;Newman, D;Dorian, P
通讯作者：
Dorian, P
影响因子：
158.5
作者：
Moss, AJ;Hall, WJ;Heo, M
通讯作者：
Heo, M
DOI：
10.1046/j.1460-9592.2003.00311.x
发表时间：
2003-10-01
影响因子：
1.8
作者：
Reek, S;Geller, JC;Klein, HU
通讯作者：
Klein, HU