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Predictors of ventricular tachyarrhythmia in patients with a wearable cardioverter defibrillator: an international multicenter registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年7月10日

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  • Fabienne Kreimer,
  • Katharina Koepsel,
  • Michael Gotzmann,
  • Boldizsar Kovacs,
  • Tobias C. Dreher,
  • Christian Blockhaus,
  • Norbert Klein,
  • Thomas Kuntz,
  • Dong-In Shin,
  • Hendrik Lapp,
  • Stephanie Rosenkaimer,
  • Mohammad Abumayyaleh,
  • Nazha Hamdani,
  • Ardan Muammer Saguner,
  • Julia W. Erath,
  • Firat Duru,
  • Thomas Beiert,
  • Fabian Schiedat,
  • Christian Weth,
  • Florian Custodis,
  • Ibrahim Akin,
  • Andreas Mügge,
  • Assem Aweimer,
  • Ibrahim El-Battrawy

摘要

Background and aims

Wearable cardioverter defibrillator (WCD) can protect patients from sudden cardiac death due to ventricular tachyarrhythmias and serve as a bridge to decision of definite defibrillator implantation. The aim of this analysis from an international, multicenter WCD registry was to identify predictors of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) in this population.

Methods

One thousand six hundred seventy-five patients with WCD were included in a multicenter registry from 9 European centers, with a median follow-up of 440 days (IQR 120–893). The primary study end point was the occurrence of sustained VT/VF.

Results

Sustained VT was detected by WCD in 5.4% and VF in 0.9% of all patients. Of the 30.3% of patients receiving ICD implantation during follow-up, sustained VT was recorded in 9.3% and VF in 2.6%. Non-ischemic cardiomyopathy (HR 0.5, p < 0.001), and medication with angiotensin-converting enzyme inhibitors (HR 0.7, p = 0.027) and aldosterone antagonists (HR 0.7, p = 0.005) were associated with a significantly lower risk of VT/VF.

Conclusions

Patients who received WCD due to a transient increased risk of sudden cardiac death have a comparatively lower risk of VT/VF in the presence of non-ischemic cardiomyopathy. Of note, optimal medical treatment for heart failure not only results in an improvement in left ventricular ejection fraction but also in a reduction in the risk for VT/VF.

Graphical Abstract