Journal Article

Extended follow‐up after wearable cardioverter‐defibrillator period: the PROLONG‐II study

Eiringhaus, Jörg, Zormpas, Christos, Hohmann, Stephan, Mueller‐Leisse, Johanna, Bauersachs, Johann, Veltmann, Christian, Brunn, Johanna, Duncker, David, Hillmann, Henrike Aenne Katrin

2021

Overview

Aim The wearable cardioverter‐defibrillator (WCD) is used for temporary protection from sudden cardiac death (SCD) in patients with newly diagnosed heart failure with reduced ejection fraction before considering an implantable cardioverter‐defibrillator (ICD). However, the prognostic significance of the WCD remains controversial due to conflicting evidence. The aim of the present study was to evaluate prognosis of patients receiving life‐saving WCD shocks. Methods and results All patients receiving a WCD at Hannover Medical School for heart failure with reduced ejection fraction between 2012 and 2017 were included. Data were acquired at baseline, at 3 months and at last available follow‐up (FU). Three hundred and fifty‐three patients were included (69% male; age 56 ± 15 years; left ventricular ejection fraction 25 ± 8%). FU after the WCD was 2.8 ± 1.5 years with a maximum of 6.8 years. Daily WCD wear time was 22 ± 4 h. Fourteen patients (4%) received appropriate WCD shocks. Two patients (0.6%) died during the WCD period. Thirty patients (9%) died during extended FU. Mean estimated survival after the WCD was similar between patients with and without WCD shocks. Patients without an ICD recommendation after WCD prescription did not experience SCD during FU. Conclusions Patients with WCD shocks showed a favourable survival. Patients without an ICD recommendation after WCD prescription had no SCD during FU. These findings support the practice of careful risk stratification before considering an ICD and the use of the WCD for temporary protection from SCD.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Aged / Cardiac arrhythmia / Cardiomyopathy / Defibrillators / Defibrillators, Implantable / Ejection fraction / Electrocardiography / Female / Follow-Up Studies / Heart failure / Humans / Implantable cardioverter‐defibrillator / Ischemia / Male / Middle Aged / Mortality / Myocarditis / Original / Patients / Regression analysis / Statistical analysis / Stroke Volume / Sudden cardiac death / Survival analysis / Ventricular Function, Left / Wearable cardioverter‐defibrillator / Wearable Electronic Devices