A standardized training and adherence surveillance programme for wearable cardioverter defibrillators increased median daily wear time compared to a historical cohort (23.3 vs 21.9 hours/day, p<0.01).
Cohort (n=92)
No
Does a standardized training and adherence surveillance programme improve compliance and quality of life in patients treated with a wearable cardioverter defibrillator?
A standardized training and adherence surveillance program for patients with wearable cardioverter defibrillators significantly improves daily wear time and quality of life.
Absolute Event Rate: 23.3% vs 21.9%
p-value: p=<0.01
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. Keywords: wearable cardioverter-defibrillator, sudden cardiac death, quality-of-life, ventricular tachycardia, ventricular fibrillation, life vest
Kellnar et al. (Wed,) conducted a cohort in Temporary contraindications for implantation of a permanent cardioverter defibrillator (n=92). Standardized WCD training and adherence surveillance programme vs. Historical cohort (no additional training programme) was evaluated on Median daily wear time (hours/day) (p=<0.01). A standardized training and adherence surveillance programme for wearable cardioverter defibrillators increased median daily wear time compared to a historical cohort (23.3 vs 21.9 hours/day, p<0.01).