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Wearable Defibrillator

Madhab Lamichhane, Joseph C Gardiner, Nicole R Bianco, Steven J Szymkiewicz, Ranjan K Thakur
PURPOSE: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF). METHODS: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use...
October 17, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sven Reek, Haran Burri, Paul R Roberts, Christian Perings, Andrew E Epstein, Helmut U Klein
The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the underlying pathology is potentially reversible or who are awaiting an implantable cardioverter-defibrillator. The use of the wearable cardioverter-defibrillator is included in the new 2015 ESC guidelines for the management of ventricular arrhythmias and prevention of sudden cardiac death. The present review provides insight into the current technology and an overview of this approach...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Thomas A Mavrakanas, David M Charytan
PURPOSE OF REVIEW: This review article focuses on the most significant cardiovascular complications in dialysis patients [sudden cardiac death (SCD), acute coronary syndromes, heart failure, and atrial fibrillation]. RECENT FINDINGS: Current and ongoing research aims to quantify the rate and pattern of significant arrhythmia in dialysis patients and to determine the predominant mechanism of SCD. Preliminary findings from these studies suggest a high rate of atrial fibrillation and that bradycardia and asystole may be more frequent than ventricular arrhythmia as a cause of sudden death...
November 2016: Current Opinion in Nephrology and Hypertension
Shingo Sasaki, Yoshihiro Shoji, Yuji Ishida, Takahiko Kinjo, Yuichi Tsushima, Maiko Seno, Fumie Nishizaki, Taihei Itoh, Kei Izumiyama, Takashi Yokota, Hiroaki Yokoyama, Masahiro Yamada, Daisuke Horiuchi, Masaomi Kimura, Takumi Higuma, Hirofumi Tomita, Ken Okumura
BACKGROUND: The wearable cardioverter-defibrillator (WCD) has been expected to play a role as an effective bridge therapy to implantable cardioverter-defibrillator (ICD) implantation in patients at high risk of ventricular tachyarrhythmias (VA). Although WCD has been available since April 2014 in Japan, its usefulness remains unclear. METHODS AND RESULTS: During the early period after hospitalization, patients at high risk of VA after excluding some elderly patients were prescribed WCD...
September 3, 2016: Journal of Cardiology
Yusuke Kondo, Marehiko Ueda, Yoshio Kobayashi, Joerg O Schwab
There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur...
August 2016: Journal of Arrhythmia
Nobuhiro Nishii
Arrhythmic management is needed after removal of cardiac implantable electronic devices (CIEDs). Patients completely dependent on CIEDs need temporary device back-up until new CIEDs are implanted. Various methods are available for device back-up, and the appropriate management varies among patients. The duration from CIED removal to implantation of a new CIED also differs among patients. Temporary pacing is needed for patients with bradycardia, a wearable cardioverter defibrillator (WCD) or catheter ablation is needed for patients with tachyarrhythmia, and sequential pacing is needed for patients dependent on cardiac resynchronization therapy...
August 2016: Journal of Arrhythmia
L Eckardt, T Deneke
The 2015 European Society of Cardiology Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death is an update of the former 2006 European/American guidelines. This new consensus document gives a detailed overview on prevention and therapy of ventricular arrhythmias and sudden cardiac death. This includes detailed discussion of channelopathies and various cardiomyopathies. Gaps in evidence are identified and also discussed. DNA analysis and postmortem assessment in sudden cardiac death victims is for the first time part of these new recommendations...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Byron K Lee, Jeffrey E Olgin
No abstract text is available yet for this article.
August 30, 2016: Circulation
Parikshit S Sharma, Pierre Bordachar, Kenneth A Ellenbogen
The implantable cardiac defibrillator (ICD) has been an effective tool for prevention of sudden cardiac death (SCD) in populations at high risk for life-threatening sustained ventricular tachycardia (VT) and ventricular fibrillation (VF). However, ICD implantation is dependent on defining ventricular substrate, evaluating the future risk of SCD and estimation of the patient's overall survival. The ability to predict risk of SCD is often difficult. If ventricular dysfunction (a surrogate marker for the risk of SCD) improves, ICD therapy may not be indicated...
August 25, 2016: European Heart Journal
Aileen M Ferrick, David Tian, Vijaya Vudathaneni, Olga L Shevchuk, Neal J Ferrick, William Frishman
The use of implantable cardioverter defibrillators (ICD) has favorably impacted the prevention and treatment of sudden cardiac death (SCD) associated with ventricular arrhythmias. However, there are situations where an ICD cannot be immediately implanted, even though the patient is at high risk for SCD. The wearable cardioverter defibrillator (WCD) is a unique technology that can bridge this gap for patients. The WCD has been demonstrated to terminate ventricular tachycardia/fibrillation if worn and used correctly...
November 2016: Cardiology in Review
E Reuschel, A Baessler, C Stöllberger, J Finsterer, L Maier, M Fischer, F Poschenrieder, F Heissenhuber, K Kurzidim, C P Schepp, G Badelt, B Seelbach-Göbel
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Lars Eckardt, Julia Köbe, Kristina Wasmer
The 2016 ESC guideline on prevention and therapy of ventricular tachyarrhythmias and sudden cardiac death present an excellent recommendation and summary for all forms of ventricular tachyarrhythmias in patients with and without structural or electrical heart disease. This includes cardiomyopathies as well as conditions such as proarrhythmia, neurologic/psychaitric disorders, or pregnancy. Some aspects are novel; (1) the guideline emphasizes for the first time genetic work-up in sudden cardiac death victims; (2) for prevention of sudden cardiac death systematic re-evaluation 6-12 weeks after myocardial infarction is recommended; (3) subcutaneous ICD as well as the wearable cardioverter/defibrillator are for the first time included in the guidelines; (4) automatic external defibrillators are recommended for public places; (5) for patients with recurrent ventricular tachyarrhythmias the role of catheter ablation has been upgraded...
August 2016: Deutsche Medizinische Wochenschrift
Roderick Willem Treskes, Enno Tjeerd van der Velde, Rogier Barendse, Nico Bruining
INTRODUCTION: Recent developments in implantable cardioverter-defibrillators (ICDs) and smartphone technology have increased the possibilities for remote monitoring. It is the purpose of this review to give an overview of these new possibilities. AREAS COVERED: Remote monitoring in ICD allows for early detection of lead fractures and remote follow-up of patients. Possible limitations are the lack of standardization and the possible unsafety of the data stored on the ICD...
September 2016: Expert Review of Medical Devices
D Duncker, J Bauersachs, C Veltmann
In the majority of cases sudden cardiac death (SCD) is caused by ventricular tachyarrhythmia. Implantable cardioverter-defibrillators (ICD) represent an evidence-based and established method for prevention of SCD. For patients who do not fulfill the criteria for guideline-conform implantation of an ICD but still have an increased, e.g. transient risk for SCD, a wearable cardioverter-defibrillator (WCD) vest was developed to temporarily prevent SCD. Numerous studies have shown the safety and efficacy of the WCD, although there is still a gap in evidence concerning a reduction in overall mortality and improvement in prognosis...
September 2016: Der Internist
Nadine K Wäßnig, Michael Günther, Silvio Quick, Christian Pfluecke, Fabian Rottstädt, Steven J Szymkiewicz, Steven Ringquist, Ruth H Strasser, Uwe Speiser
BACKGROUND: This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation. METHODS: From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers. Deidentified German patient data were used for a retrospective, nonrandomized analysis. RESULTS: Ninety-four patients (1...
August 30, 2016: Circulation
Daira Wilson
PROBLEM: Wearable technology is here and nurses are going to be increasingly responsible for patients who use it. Most research in this area has been done in other fields and now is the time for nurses to be more involved in this promising technology to improve patient lives. METHODS: This paper synthesizes the current state of wearable technology, a brief history of nurse satisfaction with technology, current research about wearable technology, and implications for its future use in nursing...
July 25, 2016: Nursing Forum
Aleksandr Voskoboinik, Jason Bloom, Andrew Taylor, Justin Mariani
BACKGROUND: Primary prevention implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients with severe systolic dysfunction. Current guidelines suggest a 3- to 6-month waiting period before implantation. METHODS: We retrospectively studied 29 consecutive patients with newly diagnosed nonischemic cardiomyopathy (NICM) who underwent primary prevention ICD implantation within 6 months of diagnosis between January 2008 and April 2014. Cardiac MRI (CMR) evaluated left ventricular ejection fraction (LVEF) and regional fibrosis preimplant...
September 2016: Pacing and Clinical Electrophysiology: PACE
David E Kandzari, Ramu Perumal, Deepak L Bhatt
BACKGROUND: Autopsy studies imply that recurrent myocardial infarction (MI) accounts for the majority of sudden death early after acute MI, rather than primary arrhythmia. However, diagnosis of recurrent MI by autopsy is challenging and excludes electrocardiographic data to adjudicate arrhythmic causes. We examined the frequency of ischemia prior to treated ventricular tachycardia/fibrillation (VT/VF) and outcomes in patients using the wearable cardioverter defibrillator (WCD) following acute MI...
July 2016: Clinical Cardiology
Alon Barsheshet, Theodora Vamvouris, Ilan Goldenberg
INTRODUCTION: Ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) can lead to aborted cardiac arrest or sudden cardiac death in patients with poor left ventricular function early after acute myocardial infarction (AMI). Although it has been shown that the implantable cardioverter defibrillator (ICD) can treat ventricular tachyarrhythmias and save lives in patients with ischemic cardiomyopathy, it's use during the early phase post AMI has not been shown to reduce mortality...
July 2016: Expert Review of Medical Devices
Madhab Lamichhane, Abdul Safadi, Phani Surapaneni, Negar Salehi, Ranjan K Thakur
The United States Food and Drug Administration has approved the wearable cardioverter defibrillator (WCD) for use in patients who are at high risk for sudden cardiac arrest (SCA) and who do not yet have an established indication for an implantation cardioverter defibrillator (ICD) or have contraindications for device implantation for various reasons. The WCD is typically used for primary prevention in (1) high-risk patients with reduced left ventricular ejection fraction (LVEF) ≤35 % after recent acute myocardial infarction (MI) during the 40-day ICD waiting period, (2) before and after coronary artery bypass graft or percutaneous coronary intervention during the 90-day ICD waiting period, (3) after recently diagnosed nonischemic dilated cardiomyopathy (NICM) during the 3- to 9-month medical therapy optimization period, or (4) for those with inherited proarrhythmic conditions such as long QT syndrome or hypertrophic cardiomyopathy...
August 2016: Current Cardiology Reports
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