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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Extended follow-up after wearable cardioverter-defibrillator period: the PROLONG-II study

Johanna Mueller-Leisse1, Johanna Brunn1, Christos Zormpas1

  • 1Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.

ESC Heart Failure
|September 4, 2021
PubMed

Insights

Patients using a wearable cardioverter-defibrillator (WCD) for heart failure experienced favorable survival, even after receiving life-saving shocks. Careful risk assessment before implantable cardioverter-defibrillator (ICD) use is supported by these findings.

Area of Science:

  • Cardiology
  • Medical Devices
  • Sudden Cardiac Death Prevention

Background:

  • The wearable cardioverter-defibrillator (WCD) offers temporary protection against sudden cardiac death (SCD) for heart failure patients.
  • Its prognostic significance is debated due to conflicting research.
  • This study evaluates outcomes for patients who received life-saving shocks from a WCD.

Purpose of the Study:

  • To assess the prognosis of patients treated with a wearable cardioverter-defibrillator (WCD).
  • To evaluate the impact of WCD shocks on patient survival.
  • To determine the role of WCDs in guiding decisions about implantable cardioverter-defibrillators (ICDs).

Main Methods:

  • Retrospective analysis of 353 heart failure patients using a WCD (2012-2017).
  • Data collected at baseline, 3 months, and last follow-up (FU).
  • Analysis included WCD shock events, mortality, and ICD recommendations.

Main Results:

  • 14 patients (4%) received appropriate WCD shocks; 2 died during WCD use.
  • 30 patients (9%) died during extended FU.
  • Survival was similar between patients with and without WCD shocks; no SCD occurred in patients not recommended for an ICD post-WCD.

Conclusions:

  • Patients experiencing WCD shocks demonstrated favorable survival outcomes.
  • No sudden cardiac death (SCD) was observed in patients not recommended for an implantable cardioverter-defibrillator (ICD) after WCD use.
  • Findings support WCDs for temporary SCD protection and careful pre-ICD risk stratification.
Abstract

Keywords:
Heart failureImplantable cardioverter-defibrillatorSudden cardiac deathWearable cardioverter-defibrillator

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