Age differences of patients treated with wearable cardioverter defibrillator: Data from a multicentre registry

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Ibrahim El-Battrawy - , BG University Hospital Bergmannsheil Bochum (Author)
  • David Tenbrink - , BG University Hospital Bergmannsheil Bochum (Author)
  • Boldizsar Kovacs - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Tobias C Dreher - , University of Mannheim, University Hospital Heidelberg (Author)
  • Christian Blockhaus - , Helios Klinikum Pirna (Author)
  • Norbert Klein - , Helios Klinikum Pirna (Author)
  • Dong-In Shin - , Helios Klinikum Pirna (Author)
  • Mido Hijazi - , Department of Neurosurgery, University Vascular Centre (Author)
  • Stephanie Rosenkaimer - , Universitätsmedizin Mannheim (Author)
  • Thomas Beiert - , Universitätsmedizin Mannheim (Author)
  • Mohammad Abumayyaleh - , Universitätsmedizin Mannheim (Author)
  • Ardan Muammer Saguner - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Jacqueline Kowitz - , Universitätsmedizin Mannheim (Author)
  • Julia W Erath - , Goethe University Frankfurt a.M. (Author)
  • Firat Duru - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Andreas Mügge - , BG University Hospital Bergmannsheil Bochum (Author)
  • Assem Aweimer - , BG University Hospital Bergmannsheil Bochum (Author)
  • Ibrahim Akin - , Universitätsmedizin Mannheim (Author)

Abstract

BACKGROUND: Wearable cardioverter defibrillators (WCD) are used as a 'bridging' technology in patients, who are temporarily at high risk for sudden cardiac death (SCD). Several factors should be taken into consideration, for example patient selection, compliance and optimal drug treatment, when WCD is prescribed. We aimed to present real-world data from seven centres from Germany and Switzerland according to age differences regarding the outcome, prognosis, WCD data and compliance.

MATERIALS AND METHODS: Between 04/2012 and 03/2021, 1105 patients were included in this registry. Outcome data according to age differences (old ≥45 years compared to young <45 years) were analysed. At young age, WCDs were more often prescribed due to congenital heart disease and myocarditis. On the other hand, ischaemic cardiomyopathy (ICM) was more present in older patients. Wear days of WCD were similar between both groups (p = .115). In addition, during the WCD use, documented arrhythmic life-threatening events were comparable [sustained ventricular tachycardia: 5.8% vs. 7.7%, ventricular fibrillation (VF) .5% vs. .6%] and consequently the rate of appropriate shocks was similar between both groups. Left ventricular ejection fraction improvement was documented over follow-up with a better improvement in younger patients as compared to older patients (77% vs. 63%, p = .002). In addition, at baseline, the rate of atrial fibrillation was significantly higher in the older age group (23% vs. 8%; p = .001). The rate of permanent cardiac implantable electronic device implantation (CiED) was lower in the younger group (25% vs. 36%, p = .05). The compliance rate defined as wearing WCD at least 20 h per day was significantly lower in young patients compared to old patients (68.9% vs. 80.9%, p < .001). During the follow-up, no significant difference regarding all-cause mortality or arrhythmic death was documented in both groups. A low compliance rate of wearing WCD is predicted by young patients and patients suffering from non-ischaemic cardiomyopathies.

CONCLUSION: Although the compliance rate in different age groups is high, the average wear hours tended to be lower in young patients compared to older patients. The clinical events were similar in younger patients compared to older patients.

Details

Original languageEnglish
Article numbere13977
JournalEuropean journal of clinical investigation
Volume53
Issue number7
Publication statusPublished - Jul 2023
Peer-reviewedYes

External IDs

Scopus 85150451800

Keywords

Keywords

  • Aged, Atrial Fibrillation/complications, Death, Sudden, Cardiac/epidemiology, Defibrillators/adverse effects, Humans, Middle Aged, Myocardial Ischemia/therapy, Registries, Retrospective Studies, Stroke Volume, Ventricular Function, Left, Wearable Electronic Devices