Key result
WCD successfully converts all VT/VF episodes in cardiac sarcoidosis, yielding 100% post-shock survival.
Why the study?
Does the wearable cardioverter defibrillator successfully treat ventricular tachycardia/fibrillation and prevent sudden cardiac death in patients with cardiac sarcoidosis?
Cohort (n=46)
Does the wearable cardioverter defibrillator successfully treat ventricular tachycardia/fibrillation and prevent sudden cardiac death in patients with cardiac sarcoidosis?
The wearable cardioverter defibrillator effectively terminates ventricular tachyarrhythmias and prevents sudden cardiac death in high-risk patients with cardiac sarcoidosis, serving as a safe bridge to ICD implantation or LVEF recovery.
Answers are grounded in this paper and cite their sources.
Supports WCD efficacy in cardiac sarcoidosis; hypothesis-generating and should not yet change practice.
BACKGROUND: Patients with cardiac sarcoidosis are at increased risk of ventricular tachycardia/fibrillation. OBJECTIVE: We tested the hypothesis that the wearable cardioverter defibrillator can be used to mitigate the risk of sudden cardiac death among cardiac sarcoidosis patients. METHODS: A retrospective review of the commercial database identified cardiac sarcoidosis patients who wore the wearable cardioverter defibrillator. Evidence for cardiac sarcoidosis diagnosis as well as demographic, co-morbidity and left ventricular ejection fraction were provided by patient clinical records. Clinical data also included daily wearable cardioverter defibrillator wear, shock treatment and survival information. RESULTS: The wearable cardioverter defibrillator was worn by 46 cardiac sarcoidosis patients, 24 (52%) male. The median age was 48 years and median left ventricular ejection fraction was 30%. The wearable cardioverter defibrillator was worn a median of 23.6 hours each day. There were 11 ventricular tachycardia/fibrillation episodes occurring in 10 (22%) patients. Ventricular tachycardia/fibrillation occurred over a range of 1 to 79 days, median 24 days. First-shock success for conversion of ventricular tachycardia/fibrillation was 100%. Patient survival 24 hours after shock treatment was 100%. Follow up to determine the reason for discontinuing wearable cardioverter defibrillator use indicated that among shocked patients 7 received an implantable cardioverter defibrillator, 1 patient was admitted to the hospital ending in death 2 weeks after discontinuing wearable cardioverter defibrillator use, and 2 patients were lost to follow up. Among the not shocked patients, there were 16 who received an implantable cardioverter defibrillator while 7 achieved improved left ventricular ejection fraction. CONCLUSION: Management of sudden cardiac death among cardiac sarcoidosis patients was aided by the wearable cardioverter defibrillator resulting in successful termination of ventricular tachycardia/fibrillation upon delivery of shock.
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Skowasch et al. (2018) conducted a cohort in Cardiac sarcoidosis (n=46). Wearable cardioverter defibrillator was evaluated on First-shock success for conversion of ventricular tachycardia/fibrillation. The wearable cardioverter defibrillator successfully converted all 11 episodes of ventricular tachycardia/fibrillation in cardiac sarcoidosis patients, resulting in 100% survival 24 hours post-shock.
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