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Article Dans Une Revue EP-Europace Année : 2021

Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study

1 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
2 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
3 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
4 Medicover Hospitals, Hyderabad, India
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 Service Rythmologie
7 CHU Nancy - Centre Hospitalier Universitaire de Nancy
8 Hôpital Brabois
9 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
10 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
11 Department of Cardiology
12 UCBL - Université Claude Bernard Lyon 1
13 EAS - European Atherosclerosis Society [Göteborg, Sweden]
14 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
15 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
16 TIMONE - Hôpital de la Timone [CHU - APHM]
17 CHU Clermont-Ferrand
18 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
19 CHRO - Centre Hospitalier Régional d'Orléans
20 CHU Limoges
21 Hôpital Saint Philibert [Lomme]
22 CHU Amiens-Picardie
23 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
24 CHA - Centre hospitalier d'Auxerre
25 Hôpital Henri Mondor
26 Centre Hospitalier Sud Francilien
27 Hôpital Privé Jacques Cartier [Massy]
28 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
29 Centre de convalescence gériatrique de Fontaine
30 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
31 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
32 CHU Pessac
33 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
34 Centre Hospitalier de Cannes
35 CH Angoulême - Centre Hospitalier d'Angoulême
36 Cardiopathies et mort subite [ERL 3147]
37 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
38 CCN - Centre cardiologique du Nord
39 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
40 LTSI - Laboratoire Traitement du Signal et de l'Image
Serge Boveda
  • Fonction : Auteur
Benoit Guy-Moyat
  • Fonction : Auteur
Philippe Ritter
  • Fonction : Auteur
Eloi Marijon

Résumé

Abstract Aims We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability. Methods and results Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services. Overall, 1157 patients were included (mean age 60 ± 12 years, 16% women; 46% prospectively): 82.1% with ischaemic cardiomyopathy, 10.3% after implantable cardioverter-defibrillator explant, and 7.6% before heart transplantation. Median WCD usage period was 62 (37–97) days. Median daily wear time of WCD was 23.4 (22.2–23.8) h. In multivariate analysis, younger age was associated with lower compliance [adjusted odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95–0.99, P < 0.01]. A total of 18 participants (1.6%) received at least one appropriate shock, giving an incidence of appropriate therapy of 7.2 per 100 patient-years. Patient-response button allowed the shock to be aborted in 35.7% of well-tolerated sustained ventricular arrhythmias and in 95.4% of inappropriate ventricular arrhythmia detection, finally resulting in an inappropriate therapy in eight patients (0.7%). Conclusion Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients. Moreover, they emphasize the fact that when prescribed appropriately, in concert with adequate patient education and dedicated follow-up using specific remote monitoring system, compliance with WCD is high and the device well-tolerated by the patient.

Dates et versions

hal-04073508 , version 1 (18-04-2023)

Identifiants

Citer

Rodrigue Garcia, Nicolas Combes, Pascal Defaye, Kumar Narayanan, Laurence Guedon-Moreau, et al.. Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study. EP-Europace, 2021, 23 (1), pp.73-81. ⟨10.1093/europace/euaa268⟩. ⟨hal-04073508⟩
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