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• W2126804979 abstract "Tachycardia-induced cardiomyopathy (TIC) is considered a reversible form of left ventricular dysfunction. Although patients with TIC are at high risk of sudden cardiac arrest, once the heart rate is under control rapid clinical improvement is expected. Hence, an implantable defibrillator (ICD) may not be an optimal clinical solution before a permanent risk is identified. Moreover, the tachycardia burden (usually of supraventricular origin) makes TIC patients more susceptible to false shocks. Previous studies have reported the effectiveness of a wearable cardioverter defibrillator (WCD) in terminating life-threatening ventricular arrhythmias (VAs). In addition to its arrhythmia detection algorithm, the WCD has response buttons that allow a conscious patient to avoid unnecessary shocks. The current study sought to examine the use of the WCD in TIC patients. Between January 2008 and January 2014, medical orders (MOs) indicating a TIC were selected from the manufacturer-maintained WCD registry (ZOLL, Pittsburgh, PA) for the analysis. Demographics, clinical background, length of use, daily compliance, treatment events, and end of use reasons were reviewed. A total of 84 patients (female=25%, age=60±11 years) were identified for this analysis. Atrial fibrillation caused TIC in 78 (93%) of the cases, while other supraventricular tachycardia were responsible for 5 (6%) and incessant ventricular ectopy for 1(1%). Forty (48%) had new onset of tachyarrhythmia (<1 month), while 34 (40%) had a tachycardia history of > 1 month (10 were unknown). Clinical characteristics between the two subgroups are summarized in Table 1. On average, patients were prescribed the device for 74±43 days; 22 (26%) had their use extended by their physicians upon EF re-evaluation when the initial MO expired. Median daily wear time was 21.7 hours. Two (2%) patients experienced 5 VAs and received 5 successful defibrillations. Both survived and received ICDs. The false shock rate was 1.5% per patient-month of use. Forty two (50%) patients recovered with improved EF > 35% at the end of WCD use, among whom the average length of use was 84±44 days (median=86). Other end of use reasons included 11 (13%) with ICD implantation, 1 (1%) due to death, and 30 (36%) with other reasons. The EF improvement rate was high among TIC patients within the first 3 months after the initiation of anti-tachycardia medication. The WCD was safe and effective in bridging TIC patients to either recovery or a permanent clinical solution, such as ICD.Table 1History ofTachycardiaCharacteristics<1 month (n=40)>1 month (n=34)*Age, years61±1156±10Female gender, n (%)10 (25)10 (29)EF, %26±525±9Admission Heart Rate, beats per minute128±26116±23Heart Failure, n (%)28 (76) N=3724 (25) N= 32COPD, n (%)4 (10) N= 394 (13) N=30*HTN, n (%)9 (23)2 (6)Substance Abuse, n(%)9 (24) N= 3810 (30) N=33Tobacco Use, n (%)17 (46) N= 3711 (34) N= 32Medication, n (%) Beta Blocker, n (%)27 (68)28 (82) Aspirin, n (%)14 (35)11 (32) Warfarin, n (%)11 (28)12 (35) Digoxin, n (%)12 (30)6 (18) Amiodarone, n (%)13 (33)6 (18) Dofetilide, n (%)1 (3)3 (9) Tricyclic Anti-depressant, n (%)5 (13)1 (3) Benzodiazepine, n (%)1 (3)5 (15)EF Recovery, n (%)20 (50)17 (50)*p<0.05. Open table in a new tab" @default.
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• W2126804979 date "2014-08-01" @default.
• W2126804979 modified "2023-09-27" @default.
• W2126804979 title "Bridging to Recovery: Experience with the Wearable Cardioverter Defibrillator in Patients with Tachycardia-Induced Cardiomyopathy" @default.
• W2126804979 doi "https://doi.org/10.1016/j.cardfail.2014.06.249" @default.
• W2126804979 hasPublicationYear "2014" @default.
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