Wearable cardioverter defibrillator after cardiac surgery: Analysis of real-life data from patients at transient risk of sudden cardiac death

Abstract BackgroundEspecially in the first 3 months after cardiac surgery, patients are at transient risk of sudden cardiac death (SCD). To close the gap between hospital discharge and the final implantable cardioverter-defibrillator (ICD) decision, guidelines recommend the temporary use of a wearable cardioverter-defibrillator (WCD) to protect these patients from SCD. We investigated real-life data on the safety, effectiveness, and compliance of the WCD in this population.MethodsData for analysis were collected via the Zoll Patient Management Network (ZPM) from patients who underwent cardiac surgery and who were discharged with a WCD between 2018 and 2021 at the Cardiac Surgery Center of the University of Erlangen in Germany.ResultsThe majority of the 55 patients were male (90.9%) and underwent a coronary artery bypass graft (80.0%). The number of patients with left ventricular ejection fraction (LVEF) > 35% increased from 9.1% at the beginning of WCD use to 58.2% at the end of WCD use. 6 ventricular tachycardia (VT) episodes occurred in 4 patients. 2 patients with VT episodes were appropriately defibrillated by the WCD. There were no inadequate shocks and no fatalities during the observation time. WCD wearing compliance was high with a median wear time of 23.3 hours/day.ConclusionThis retrospective analysis in a single cardiac surgery center confirms prior data on safety and effectiveness of the WCD in patients in post-surgery care in a real-life setting. The WCD successfully protected patients from SCD during life-threatening VT episodes. WCD wearing compliance was high.