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The use of wearable cardioverter-defibrillators in Europe: results of the European Heart Rhythm Association survey
Silesian Med Univ, Silesian Ctr Heart Dis, Dept Cardiol Congenital Heart Dis & Electrotherap, Curie Sklodowskiej 9, PL-41800 Zabrze, Poland..
Univ Belgrade, Sch Med, Cardiol Clin, Clin Ctr Serbia, Belgrade, Serbia..
Univ Oslo, Rikshosp, Oslo Univ Hosp, Dept Cardiol, N-0027 Oslo, Norway..
Hosp Ramon & Cajal, Dept Cardiol, E-28034 Madrid, Spain..
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2016 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 18, no 1, 146-150 p.Article in journal (Refereed) PublishedText
Abstract [en]

The aim of this European Heart Rhythm Association (EHRA) survey was to collect data on the use of wearable cardioverter-defibrillators (WCDs) among members of the EHRA electrophysiology research network. Of the 50 responding centres, 23 (47%) reported WCD use. Devices were fully reimbursed in 17 (43.6%) of 39 respondents, and partially reimbursed in 3 centres (7.7%). Eleven out of 20 centres (55%) reported acceptable patients' compliance (WCD worn for > 90% of time). The most common indications for WCD (8 out of 10 centres; 80%) were covering the period until re-implantation of ICD explanted due to infection, in patients with left ventricular impairment due to myocarditis or recent myocardial infarction and those awaiting heart transplantation. Patient life expectancy of < 12 months and poor compliance were the most commonly reported contraindications for WCD (24 of 46 centres, 52.2%). The major problems encountered by physicians managing patients with WCD were costs (8 of 18 centres, 44.4%), non-compliance, and incorrect use of WCD. Four of 17 centres (23.5%) reported inappropriate WCD activations in < 5% of patients. The first shock success rate in terminating ventricular arrhythmias was 95-100% in 6 of 15 centres (40%), 85-95% in 4 (26.7%), 75-85% in 2 (13.3%), and < 75% in 3 centres (20%). The survey has shown that the use of WCD in Europe is still restricted and depends on reimbursement. Patients' compliance remains low. Heterogeneity of indications for WCD among centres underscores the need for further research and a better definition of indications for WCD in specific patient groups.

Place, publisher, year, edition, pages
2016. Vol. 18, no 1, 146-150 p.
Keyword [en]
Wearable cardioverter-defibrillator, Implantable cardioverter-defibrillator, Sudden cardiac death, Ventricular arrhythmias, Prevention, Heart failure, EHRA survey, EP wire
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-282649DOI: 10.1093/europace/euw003ISI: 000370982800020PubMedID: 26842735OAI: oai:DiVA.org:uu-282649DiVA: diva2:917474
Available from: 2016-04-06 Created: 2016-04-06 Last updated: 2016-04-06Bibliographically approved

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