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Study of the wearable cardioverter defibrillator in advanced heart-failure patients (SWIFT)

Alon Barsheshet1,2, Valentina Kutyifa2, Theodora Vamvouris1

  • 1Cardiology Department, Rabin Medical Center, Petah Tikva, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Journal of Cardiovascular Electrophysiology
|April 22, 2017
PubMed

Insights

The wearable cardioverter defibrillator (WCD) safely bridges the decision for implantable cardioverter defibrillator (ICD) in advanced heart failure (HF) patients. This study found no deaths during WCD use, demonstrating its safety in high-risk HF populations.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Wearable cardioverter defibrillators (WCD) offer a potential bridge to implantable cardioverter defibrillator (ICD) assessment for high-risk heart failure (HF) patients.
  • Limited data exists on WCD efficacy in acute decompensated HF.
  • This study addresses the WCD's role in advanced HF management.

Purpose of the Study:

  • To evaluate the safety and efficacy of the WCD in patients hospitalized with advanced heart failure.
  • To assess arrhythmic events, WCD use, and mortality in this patient population.
  • To determine if WCD management is a viable strategy for guiding ICD implantation decisions.

Main Methods:

  • Prospective clinical trial (SWIFT) at two medical centers.
  • Enrolled 75 advanced HF patients with reduced LVEF, prescribed WCD for 3 months.
  • Monitored arrhythmic events, WCD discharge, and death.

Main Results:

  • Mean LVEF was 21.5 ± 10.4%; 66% had non-ischemic cardiomyopathy.
  • Median WCD wear time was 59 days; 80% wore it >50% of daily hours.
  • 8 arrhythmic events in 5 patients; 1 polymorphic VT successfully terminated by WCD. No deaths or inappropriate therapies occurred during WCD use.

Conclusions:

  • A management strategy using WCD is safe for high-risk advanced HF patients.
  • WCD use effectively bridges the decision-making process for ICD implantation.
  • The WCD can be safely incorporated into the care of advanced HF patients awaiting further assessment.
Abstract

Keywords:
defibrillator shockheart failureimplantable cardioverter defibrillatorventricular tachycardiawearable cardioverter defibrillator

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