Analysis of Patients with LifeVest after Cardiac Surgery

• 作者: Andreas Smechowski Dirk Fritzsche Oliver Grimmig Soeren Just Temirlan Erkenov Vusal Hajiyev
• 来源期刊: 心血管外科国际期刊(英文)
• 学科: 医学
• 关键词: WEARABLE CARDIOVERTER-DEFIBRILLATOR LifeVest CARDIAC INSUFFICIENCY CARDIAC SURGERY
• 年，卷（期）: 2020,（5）
• 页码范围: 59-65
• 页数: 7页
• 分类号: R54

摘要

Background: Patients with left ventricular ejection fraction (LVEF) ≤ 35% are at a high risk of sudden cardiac death (SCD) and benefit from implantable cardioverter-defibrillator (ICD) therapy. ICD implantation is not indicated during the first 40 days after acute myocardial infarction and <3 months after coronary artery bypass grafting, because of possible cardiac function recovery. The wearable cardioverter defibrillator (WCD) is a therapy option for preventing sudden cardiac death at the time of recovery. This study evaluated the effectiveness of the wearable cardioverter-defibrillator in preventing SCD after cardiac surgery. Methods: This is a retrospective study conducted in the Heart Center in Cottbus. From 02.2015 through 02.2018 26 WCD patients were retrospectively analyzed and followed-up. Patient demographics, defibrillation treatments, and daily wear times were retrospectively obtained from our clinical database and LifeVest network. The patients were questioned about actual NYHA grade and implanted ICD at the end of follow-up. Results: Twenty-five patients (mean age 65, 22 men, 3 women) were treated with a WCD in response to heart failure (mean EF = 24%) after cardiac surgery (21 CABG, 1 AVR, 1 AVR + CABG, 1 AVR + MVR, MVR + CABG). Average daily use of a WCD was 22.1 (SD ± 2.7) hours which were worn for 85 days (SD ± 35). At that time 11.96 (SD ± 15) events were detected but not treated, 1 defibrillation performed and no asystole seen. At the end of follow-up (12 months, SD ± 9) 20 patients were questioned. All of the patients were alive and 5 (25%) of them were with implanted ICD. 10 (50%) patients were in NYHA grade I, 3 (12%) in NYHA grade II, 3 (12%) between grade II-III, 2 (8%) in grade III and 2 (8%) patients in NYHA grade IV. Conclusions: A WCD is an effective therapy for prevention of sudden cardiac death during the recovery period of heart function after cardiac surgery. This is treatment with high patient compliance.