High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry
Background: The wearable cardioverter defibrillator (WCD) uses surface electrodes to detect arrhythmia before initiating a treatment sequence. However, it is also prone to inappropriate detection due to artefacts. Objective: The aim of this study is to assess the alarm burden in patients and its imp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/17/3811 |
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| author | Boldizsar Kovacs Haran Burri Andres Buehler Sven Reek Christian Sticherling Beat Schaer Andre Linka Peter Ammann Andreas S. Müller Omer Dzemali Richard Kobza Matthias Schindler Laurent Haegeli Kurt Mayer Urs Eriksson Claudia Herrera-Siklody Tobias Reichlin Jan Steffel Ardan M. Saguner Firat Duru |
| author_facet | Boldizsar Kovacs Haran Burri Andres Buehler Sven Reek Christian Sticherling Beat Schaer Andre Linka Peter Ammann Andreas S. Müller Omer Dzemali Richard Kobza Matthias Schindler Laurent Haegeli Kurt Mayer Urs Eriksson Claudia Herrera-Siklody Tobias Reichlin Jan Steffel Ardan M. Saguner Firat Duru |
| author_sort | Boldizsar Kovacs |
| collection | DOAJ |
| description | Background: The wearable cardioverter defibrillator (WCD) uses surface electrodes to detect arrhythmia before initiating a treatment sequence. However, it is also prone to inappropriate detection due to artefacts. Objective: The aim of this study is to assess the alarm burden in patients and its impact on clinical outcomes. Methods: Patients from the nationwide Swiss WCD Registry were included. Clinical characteristics and data were obtained from the WCDs. Arrhythmia recordings ≥30 s in length were analysed and categorized as VT/VF, atrial fibrillation (AF), supraventricular tachycardia (SVT) or artefact. Results: A total of 10653 device alarms were documented in 324 of 456 patients (71.1%) over a mean WCD wear-time of 2.0 ± 1.6 months. Episode duration was 30 s or more in 2996 alarms (28.2%). One hundred and eleven (3.7%) were VT/VF episodes. The remaining recordings were inappropriate detections (2736 (91%) due to artefacts; 117 (3.7%) AF; 48 (1.6%) SVT). Two-hundred and seven patients (45%) had three or more alarms per month. Obesity was significantly associated with three or more alarms per month (<i>p</i> = 0.01, 27.7% vs. 15.9%). High alarm burden was not associated with a lower average daily wear time (20.8 h vs. 20.7 h, <i>p</i> = 0.785) or a decreased implantable cardioverter defibrillator implantation rate after stopping WCD use (48% vs. 47.3%, <i>p</i> = 0.156). Conclusions: In patients using WCDs, alarms emitted by the device and impending inappropriate shocks were frequent and most commonly caused by artefacts. A high alarm burden was associated with obesity but did not lead to a decreased adherence. |
| first_indexed | 2024-03-10T08:09:28Z |
| format | Article |
| id | doaj.art-165cc9bfaa624eeab9d8e94b9c49fd53 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:09:28Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-165cc9bfaa624eeab9d8e94b9c49fd532023-11-22T10:47:46ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011017381110.3390/jcm10173811High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD RegistryBoldizsar Kovacs0Haran Burri1Andres Buehler2Sven Reek3Christian Sticherling4Beat Schaer5Andre Linka6Peter Ammann7Andreas S. Müller8Omer Dzemali9Richard Kobza10Matthias Schindler11Laurent Haegeli12Kurt Mayer13Urs Eriksson14Claudia Herrera-Siklody15Tobias Reichlin16Jan Steffel17Ardan M. Saguner18Firat Duru19Department of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Cardiology, University Hospital of Geneva, 1205 Geneva, SwitzerlandDepartment of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandHirslanden Klinik Aarau, 5001 Aarau, SwitzerlandDepartment of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Cardiology, Cantonal Hospital Winterthur, 8400 Winterthur, SwitzerlandDepartment of Cardiology, Cantonal Hospital St. Gallen, 9007 St. Gallen, SwitzerlandDepartment of Cardiology, Triemli Hospital Zurich, 8063 Zurich, SwitzerlandDepartment of Cardiac Surgery, Triemli Hospital Zurich, 8063 Zurich, SwitzerlandDepartment of Cardiology, Cantonal Hospital Lucerne, 6004 Lucerne, SwitzerlandDepartment of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Cardiology, Cantonal Hospital Aarau, 5001 Aarau, SwitzerlandDepartment of Cardiology, Cantonal Hospital Graubünden, 7000 Chur, SwitzerlandDepartment of Cardiology, GZO Regional Healthcare Center Wetzikon, 8620 Wetzikon, SwitzerlandDepartment of Cardiology, University Hospital Lausanne, 1011 Lausanne, SwitzerlandDepartment of Cardiology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandDepartment of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandBackground: The wearable cardioverter defibrillator (WCD) uses surface electrodes to detect arrhythmia before initiating a treatment sequence. However, it is also prone to inappropriate detection due to artefacts. Objective: The aim of this study is to assess the alarm burden in patients and its impact on clinical outcomes. Methods: Patients from the nationwide Swiss WCD Registry were included. Clinical characteristics and data were obtained from the WCDs. Arrhythmia recordings ≥30 s in length were analysed and categorized as VT/VF, atrial fibrillation (AF), supraventricular tachycardia (SVT) or artefact. Results: A total of 10653 device alarms were documented in 324 of 456 patients (71.1%) over a mean WCD wear-time of 2.0 ± 1.6 months. Episode duration was 30 s or more in 2996 alarms (28.2%). One hundred and eleven (3.7%) were VT/VF episodes. The remaining recordings were inappropriate detections (2736 (91%) due to artefacts; 117 (3.7%) AF; 48 (1.6%) SVT). Two-hundred and seven patients (45%) had three or more alarms per month. Obesity was significantly associated with three or more alarms per month (<i>p</i> = 0.01, 27.7% vs. 15.9%). High alarm burden was not associated with a lower average daily wear time (20.8 h vs. 20.7 h, <i>p</i> = 0.785) or a decreased implantable cardioverter defibrillator implantation rate after stopping WCD use (48% vs. 47.3%, <i>p</i> = 0.156). Conclusions: In patients using WCDs, alarms emitted by the device and impending inappropriate shocks were frequent and most commonly caused by artefacts. A high alarm burden was associated with obesity but did not lead to a decreased adherence.https://www.mdpi.com/2077-0383/10/17/3811wearable cardioverter-defibrillatoralarminappropriate therapyobesityoutcome |
| spellingShingle | Boldizsar Kovacs Haran Burri Andres Buehler Sven Reek Christian Sticherling Beat Schaer Andre Linka Peter Ammann Andreas S. Müller Omer Dzemali Richard Kobza Matthias Schindler Laurent Haegeli Kurt Mayer Urs Eriksson Claudia Herrera-Siklody Tobias Reichlin Jan Steffel Ardan M. Saguner Firat Duru High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry Journal of Clinical Medicine wearable cardioverter-defibrillator alarm inappropriate therapy obesity outcome |
| title | High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry |
| title_full | High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry |
| title_fullStr | High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry |
| title_full_unstemmed | High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry |
| title_short | High Incidence of Inappropriate Alarms in Patients with Wearable Cardioverter-Defibrillators: Findings from the Swiss WCD Registry |
| title_sort | high incidence of inappropriate alarms in patients with wearable cardioverter defibrillators findings from the swiss wcd registry |
| topic | wearable cardioverter-defibrillator alarm inappropriate therapy obesity outcome |
| url | https://www.mdpi.com/2077-0383/10/17/3811 |
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