Liang JJ, Bianco NR, Muser D, Enriquez A, Santangeli P, D’Souza BA. Outcomes after asystole events occurring during wearable defibrillator-cardioverter use. World J Cardiol 2018; 10(4): 21-25 [PMID: 29707164 DOI: 10.4330/wjc.v10.i4.21]
Corresponding Author of This Article
Dr. Benjamin A D’Souza, MD, Assistant Professor of Clinical Medicine Electrophysiology Section, Department of Cardiology, University of Pennsylvania, Perelman School of Medicine, 51 N 39th St, Philadelphia, PA 19103, United States. benjamin. d’souza@uphs.upenn.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2018; 10(4): 21-25 Published online Apr 26, 2018. doi: 10.4330/wjc.v10.i4.21
Outcomes after asystole events occurring during wearable defibrillator-cardioverter use
Jackson J Liang, Nicole R Bianco, Daniele Muser, Andres Enriquez, Pasquale Santangeli, Benjamin A D’Souza
Jackson J Liang, Daniele Muser, Andres Enriquez, Pasquale Santangeli, Benjamin A D’Souza, Department of Cardiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19103, United States
Nicole R Bianco, ZOLL, Pittsburgh, PA 15238, United States
Author contributions: Liang JJ, Bianco NR, and D’Souza BA designed the study, performed the analyses and wrote the initial manuscript draft; Muser D, Enriquez A and Santangeli P assisted with the writing of the manuscript and provided critical editing of the manuscript.
Institutional review board statement: The institutional review board at the University of Pennsylvania exempted this study from review.
Conflict-of-interest statement: Nicole R Bianco is a research scientist at ZOLL Medical Corporation; Benjamin A D’Souza has received compensation (< $10000) for speaking for ZOLL Medical Corporation. The other authors report no conflicts of interest. The other authors report no potential conflicts of interest relevant to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Benjamin A D’Souza, MD, Assistant Professor of Clinical Medicine Electrophysiology Section, Department of Cardiology, University of Pennsylvania, Perelman School of Medicine, 51 N 39th St, Philadelphia, PA 19103, United States. benjamin. d’souza@uphs.upenn.edu
Telephone: +1-215-6628000
Received: January 13, 2018 Peer-review started: January 14, 2018 First decision: February 12, 2018 Revised: March 20, 2018 Accepted: April 1, 2018 Article in press: April 1, 2018 Published online: April 26, 2018 Processing time: 103 Days and 0.4 Hours
ARTICLE HIGHLIGHTS
Research background
Outcomes in patients with asystole and severe bradycardic events is poor. The wearable cardioverter defibrillator (WCD) can deliver shocks to terminate ventricular tachycardia and fibrillation, and also alarms for asystole and severe bradycardia events which can alert bystanders to help.
Research motivation
Minimal data exists on whether WCD improves outcomes and survival in patients with asystole and severe bradycardia events.
Research objectives
This study aimed to examine whether WCD alarms for asystole improve patient outcomes and survival.
Research methods
Retrospective analysis all asystole episodes documented in the WCD registry during the year of 2013 and examination of outcomes and survival.
Research results
There were 264 asystole episodes in 257 patients and 76% of these events were considered “serious”. Overall patient survival after asystole or severe bradycardia events was 42%, and survival after “serious” asystole events was 26%. Among acute survivors, 20% later died during WCD use. Of the 86 living patients at the end of WCD use period, 48 (56%) received ICD/pacemaker and 17 (20%) improved their condition.
Research conclusions
While the current indication for WCDs in high-risk patients is to detect and treat ventricular arrhythmias, patients with reduced LVEF are also at increased risk of having severe bradycardic events. The WCD may improve survival in patients with severe bradycardic/asystolic episodes by alerting bystanders to notify emergency medical services and to perform early cardiopulmonary resuscitation, as well as to detect episodes leading to appropriate permanent device implantation.
Research perspectives
Future large prospective studies examining outcomes of WCD for asystole and severe bradycardia events are necessary to confirm a survival benefit with the device.
