Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5

A multicenter registry of the wearable cardioverter-defibrillator: the Swiss-German-Wearable Cardioverter-Registry
I. El-Battrawy1, B. Kovacs2, T. Dreher3, D. Tenbrink1, N. Klein4, S. L. Rosenkaimer5, S. Röger5, A. Mügge6, A. Aweimer6, A. M. Saguner2, J. Kowitz5, J. W. Erath-Honold7, F. Duru2, I. Akin3
1Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftlliches Universitätsklinikum Bergmannsheil, Bochum; 2Department of Cardiology, University Heart Center, University Hospital, Zuerich, CH; 3Universitätsklinikum Mannheim, Mannheim; 4Klinik für Kardiologie, Angiologie und intern. Intensivmedizin, Klinikum Sankt Georg, Leipzig; 5I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 6Medizinische Klinik II, Kardiologie, Klinikum der Ruhr-Universität Bochum, Bochum; 7Med. Klinik III - Kardiologie Zentrum der Inneren Medizin, Universitätsklinikum Frankfurt, Frankfurt am Main;

Background

Patients at high risk for sudden cardiac death (SCD) may benefit from wearable cardioverter defibrillators (WCD) to avoid immediate implantable cardioverter defibrillator (ICD) implantation. Different factors play an important role including patient selection, compliance and optimal drug treatment. We aimed to present real world data from 4 centers from Germany and Switzerland.

Methods

Between 04/2012 and 03/2019, 708 patients were included in this registry. Patients were followed up over a mean time of 28 ± 35.5 months. Outcome data including gender differences and different etiologies of cardiomyopathy were analyzed.

Results

Out of 708 patients (81.8% males, mean age 61.0 ± 14.6), 39.8% of patients had ischemic cardiomyopathy, 44.6% non-ischemic cardiomyopathy, 7.9% myocarditis, 5.4% prior need for ICD explantation and 2.1% congenital heart disease.

The mean wear time of WCD was 21.2 ± 4.3 hours per day. In 42.9% of patients an improvement of the left ventricular ejection fraction was documented. The total shock rate during follow-up was 2.7%. Whereas an appropriate WCD shock was documented in 16 patients (2.2%), 3 patients received an inappropriate ICD shock (0.5%). During follow-up, implantation of a cardiac implantable electronic device was carried out in 44.5% of patients. When comparing German patients (n=516) to Swiss patients (n=192), Swiss patients presented with longer wear days (70.72 ± 49.47days versus 58.06 ± 40.45 days; p=0.001) and a higher ICD implantation rate compared to German patients (48.4% versus 29.3%; p=0.001), although the follow-up left ventricular ejection fraction was similar between Swiss patients and German patients.

Conclusion

WCD may help characterizing patients at high risk of sudden cardiac death. The compliance rate seems to be high. Some differences may be found between Swiss and German patients, which might be related to difference of mentality of ICD implantation and wear days of WCD.


https://dgk.org/kongress_programme/jt2022/aP498.html