![]() ![]() Overall, 44% of patients were implanted with an ICD or pacemaker a median of four days after the asystole episode. Information regarding reason for WCD discontinuation is shown in Table Table2. Further analysis for patients with serious asystole episodes suggested that survival was worse when the location was in a healthcare setting (Supplemental Table).įor the 108 patients that survived the acute event, twenty-two (20%) of them later died (median 4 d post-asystole episode), while 86 (80%) survived post-WCD use. The rate of acute survival in patients with serious asystole episodes was 26%, while all 56 patients with non-serious asystole episodes survived. The majority of patients had asystole episodes that were considered serious (201 78%). Overall survival for patients with asystole episodes was 42%. AFib: Atrial fibrillation Aflutter: Atrial flutter SVT: Supraventricular tachycardia AT: Atrial tachycardia PEA: Pulseless electrical activity NA: Not reported. LVEF % (median, range) ( n = 241 reported)Ĭ P < 0.001 as no serious group compared to non-serious group using Fisher’s exact test. Survival was determined by customer call reports at the end of WCD use, or by a mortality search of the Social Security death index if the customer call report at the end of WCD use did not indicate death (data available to ). For the purposes of this study, asystole episodes occurring in a “health care setting” were defined as any events in a hospital, nursing home, or ambulance. “Acute survival” was defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. For the purposes of this study, a “serious asystole episode” was defined as any life-threatening asystole episode which either required hospitalization or led to unconsciousness or death. All episodes were manually adjudicated to ensure that a true asystole event had occurred. Episodes of post-shock asystole or asystole following untreated VT episodes were excluded from the study. To identify patients with asystole episodes, the database was retrospectively screened to identify all episodes of primary asystole ECG recordings. All patients signed consent to use their data and all data were de-identified.Īn “asystole episode” was defined as bradycardia with heart rate < 10 beats/min, or having a pause lasting ≥ 5 s. ![]() ![]() This database includes indications for WCD prescription, baseline demographics (age and gender), complaints, and all device-recorded events. We examined the incidence of WCD alerts related to outcomes in patients with asystole and/or severe bradycardia.Īll patients prescribed a WCD between Januand Decemwere analyzed using a corporate database (ZOLL LifeVest). Since the WCD alerts for asystole, it may contribute to improved outcomes in patients who suffer from severe bradycardia or asystolic cardiac arrest by alerting bystanders to perform CPR and contact EMS. Shorter time intervals between collapse to initiation of bystander cardiopulmonary resuscitation (CPR) and notification of emergency medical services (EMS) are associated with improved overall survival as well as neurologically favorable survival. Patients with OHCA due to bradycardia or asystole are less likely than those with VT or VF to arrive to the hospital alive and survive to discharge. The WCD does not have antibradycardia pacing capabilities, but does alarm and instruct bystanders to call for help and perform CPR. However, a significant percentage of recorded episodes with WCD have been asystole or severe bradycardia episodes 24.5% of SCAs in the study by Chung et al. The WCD can deliver treatment shocks to terminate these tachyarrhythmias. ![]() Most life-threatening arrhythmias recorded by the WCD are ventricular arrhythmias (VA) such as ventricular tachycardia (VT) and ventricular fibrillation (VF). The wearable cardioverter-defibrillator (WCD) has been increasingly utilized to detect and treat potentially fatal ventricular arrhythmias in high-risk patients with cardiomyopathy and low left ventricular ejection fraction (LVEF). Survival to hospital discharge for out-of-hospital cardiac arrest (OHCA) victims found to be in bradycardia or asystole is low (2%). ![]()
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