Does Patient Compliance Influence Wearable Cardioverter Defibrillator Effectiveness? A Single-Center Experience

• Published in: Journal of clinical medicine Vol. 12; no. 14; p. 4743
• Main Authors: Fazzini, Luca, Marchetti, Maria Francesca, Perra, Ferdinando, Biddau, Mattia, Massazza, Nicola, Nissardi, Vincenzo, Agus, Elena, Demelas, Roberta, Montisci, Roberta
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18.07.2023; MDPI
• Subjects: Cardiology; Cardiomyopathy; Caregivers; Clinical medicine; Defibrillators; Disease prevention; Ejection fraction; Evaluation; Heart attacks; Influence; Ischemia; Mortality; Myocarditis; Patient compliance; Patient outcomes; Software; Ultrasonic imaging; Italy; heart failure; wearable cardioverter defibrillator; acute coronary syndrome; sudden cardiac death; HFrEF
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12144743

The study was designed to assess patient adherence to wearable cardioverter defibrillator as an indicator of device effectiveness. The patient training is not widely properly standardized. We enrolled 25 patients with a wearable cardioverter defibrillator to prevent sudden cardiac death between June 2020 and August 2022. Among them, 84% were male with a median age of 63.6 years. The indication was an ischemic (44%) and a non-ischemic (56%) disease. The patients were followed-up until the decision to upgrade to an implantable device was taken. We trained the patients according to our suggested protocol. The median wear time was 90 days, and the median daily wear time was 23.5 h, similar throughout sex, age, and indication groups. In total, 24% of the participants underwent cardioverter defibrillator implantation. Between the device-implanted and non-implanted groups, left ventricular ejection fraction and left ventricular indexed end-diastolic volume were significantly different (EF 35.8 ± 12 vs. 46.4 ± 8.5%, = 0.028, iEDV 108 ± 52 vs. 70.7 ± 21.1 mL/m , = 0.024). We did not find any differences in cardiac magnetic resonance data, even though all patients who underwent device implantation had late gadolinium enhancement spots. Our results support standardized patient training to obtain great patient adherence to the instructions to the wearable device and therefore its effectiveness.