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Thorac Cardiovasc Surg 2019; 67(02): 092-097
DOI: 10.1055/s-0038-1660802
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Wearable Cardioverter–Defibrillators following Cardiac Surgery—A Single-Center Experience

Jan Heimeshoff
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Constanze Merz
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Marcel Ricklefs
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Felix Kirchhoff
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Axel Haverich
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Christoph Bara
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Christian Kühn
1   Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
› Author Affiliations
Further Information

Publication History

18 March 2018

30 April 2018

Publication Date:
20 June 2018 (online)

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Abstract

Background A wearable cardioverter–defibrillator (WCD) can terminate ventricular fibrillation and ventricular tachycardias via electrical shock and thus give transient protection from sudden cardiac death. We investigated its role after cardiac surgery.

Methods We retrospectively analyzed all patients who were discharged with a WCD from cardiac surgery department. The WCD was prescribed for patients with a left ventricular ejection fraction (LVEF) of ≤35% or an explanted implantable cardioverter–defibrillator (ICD).

Results A total of 100 patients were included in this study, the majority (n = 59) had received coronary artery bypass graft surgery. The median wearing time of a WCD patient was 23.5 hours per day. LVEF was 28.9 ± 8% after surgery and improved in the follow-up to 36.7 ± 11% (p < 0.001). Three patients were successfully defibrillated. Ten patients experienced ventricular tachycardias. No inappropriate shocks were given. An ICD was implanted in 25 patients after the WCD wearing period.

Conclusion Ventricular arrhythmias occurred in 13% of the investigated patients. LVEF improved significantly after 3 months, and thus a permanent ICD implantation was avoided in several cases. Sternotomy did not impair wearing time of the WCD. A WCD can effectively protect patients against ventricular tachyarrhythmias after cardiac surgery.

Keywords

Arrhythmia Therapy - surgical - heart failure - postoperative mortality

Note

The study was presented at the annual meeting of [blinded]. Annual meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG) on February 19th, 2018 at Leipzig, Germany.


Limitations

The study provides new data on the use of wearable defibrillators in patients following cardiac surgery, but it is limited due to its retrospective design. The results may be skewed because only 100 patients over the course of 5 years were included which led to a heterogeneous cohort.


 

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