Thorac Cardiovasc Surg 2020; 68(S 01): S1-S72
DOI: 10.1055/s-0040-1705423
Oral Presentations
Tuesday, March 3rd, 2020
Arrhythmias and Cardiac Implantable Electronic Devices
Georg Thieme Verlag KG Stuttgart · New York

Multicenter Experience with Wearable Cardioverter Defibrillators following Cardiac Surgery

C. Kühn
1   Hannover, Germany
,
P. Rellecke
2   Duesseldorf, Germany
,
D. Joskowiak
3   München, Germany
,
S. Erler
4   Bad Bevensen, Germany
,
J. Garbade
5   Leipzig, Germany
,
S. Eifert
5   Leipzig, Germany
,
P. Grieshaber
6   Gießen, Germany
,
A. Hain
7   Bad Nauheim, Germany
,
H. Burger
7   Bad Nauheim, Germany
,
M. Knaut
8   Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
13 February 2020 (online)

Objectives: Patients undergoing cardiac surgery procedures like CABG, valve replacement or reconstruction or CIED extraction and coexisting severe reduced left ventricular ejection fraction (EF < 35%) are at high risk of developing ventricular arrhythmias (VA). Therefore, the position paper of the working group on cardiac arrhythmias of the German Society for Thoracic and Cardiovascular Surgery recommends the prophylactic use of a wearable cardioverter defibrillator vest (WCD) for transient prevention of sudden cardiac death (SCD) in this patient cohort. This study aimed to analyze the incidence of postoperative VA and the role of WCD after cardiac surgery.

Methods: In this multicenter study, we retrospectively analyzed all surgical patients who were discharged with a WCD. The WCD was prescribed for patients with a postoperative persistence of a reduced left ventricular ejection fraction (LVEF) of £35% or after extraction of an indicated ICD. The clinical data were obtained from the institutions medical records. WCD-wearing time, VA, and WCD shocks were analyzed provided by the automatically recorded WCD’s ECG.

Results: A total of 1,132 patients were included. Mean age was 64.4 years, and 959 (84.7%) patients were male. Overall wearing time was 21.2 hours per day. Sixty (5.3%) patients experienced VA: 17 (1.5%) patients had ventricular fibrillation (VF) and were successfully defibrillated by the WCD. Further 43 (3.8%) patients experienced nonsustained ventricular tachycardias. No patient died while wearing the WCD. Three patients were shocked inadequately due to wrong alarm rejection.

Conclusion: The compliance of our patients was very high (21.2 hours/day), despite of sternotomy. Cardiac surgery patients with severely reduced pump function or explanted ICD were at high risk for malignant arrhythmias: 1.4% of patients were successfully defibrillated for VF and 5.3% experienced ventricular arrhythmias. WCD is feasible and can effectively protect patients of SCD after cardiac surgery.