Key result
Standardized WCD training program linked to ~1.4-hour higher median daily wear time vs. historical control.
Why the study?
WCD compliance is essential to prevent sudden cardiac death but may be hindered by poor quality-of-life during therapy.
Does a standardized training and adherence surveillance programme improve compliance and quality of life in patients treated with a wearable cardioverter defibrillator?
Cohort (n=201)
No
Does a standardized training and adherence surveillance programme improve compliance and quality of life in patients treated with a wearable cardioverter defibrillator?
Answers are grounded in this paper and cite their sources.
A standardized training and adherence surveillance program for patients with wearable cardioverter defibrillators significantly improves daily wear time and quality of life.
Background: Treatment with wearable cardioverter defibrillators (WCD) is a non-invasive, transient therapy option for prevention of sudden cardiac death (SCD) in patients with temporary contraindications for implantation of a permanent cardioverter defibrillator. Due to the constant risk of fatal arrhythmias, compliance is the fundamental requirement for effectiveness of a WCD, but this might be hindered by the poor quality-of-life (QoL) during WCD therapy. In this retrospective single-center study, we examined if a standardized WCD training and adherence surveillance programme could enhance compliance and QoL. Methods: All patients with a prescription for WCD treatment from January 2017 to August 2019 were included and received a standardized WCD training programme. QoL was validated using the modified EQ-5D-3L questionnaire. The findings were compared to a historical, previously published, retrospective cohort from our center (WCD prescription period 03/2012– 02/2016), not receiving the additional training programme. Endpoints comprised therapy adherence, arrhythmic episodes, and dimensions of QoL. Results: Ninety-two patients underwent WCD treatment in the study cohort for a median of 49 days. Median daily wear time was enhanced in the study cohort (historical cohort vs study cohort 21.9 vs 23.3 hours/per day, p < 0.01) and artefact alarms occurred less frequently (67.9% vs 48.9%, p 0.01). Major restrictions in QoL in the study cohort were found in mobility (48%), daily routine (44%), and sleep (49%), but the dimensions pain (36% vs 4%, p < 0.01), mental health (43% vs 29%, p 0.03), and restrictions in daily routine (48% vs 30%, p 0.04) improved. Conclusion: A standardized training and adherence surveillance programme might have beneficial effects on compliance and QoL. As these findings are essential for therapy success, they might potentially lead to a reduction in arrhythmic deaths in upcoming WCD trials.
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Kellnar et al. (2023) conducted a cohort in High risk of arrhythmic death with transient contraindication for ICD therapy (n=201). Standardized WCD training and adherence surveillance programme vs. Historical cohort (no structured training programme) was evaluated on Median daily wear time of the wearable cardioverter defibrillator (hours/day) (p=<0.01). A standardized training and adherence surveillance program for wearable cardioverter defibrillators significantly increased median daily wear time to 23.3 hours compared to 21.9 hours in a historical cohort without the program.
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