Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry
Background Data on the use of the wearable cardioverter‐defibrillator (WCD) among patients with myocarditis remain sparse. Consequently, evidence for guideline recommendations in this patient population is lacking. Methods and Results In total, 1596 consecutive patients were included in a multicente...
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Wiley
2023-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.030615 |
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| author | Ibrahim El‐Battrawy Katharina Koepsel David Tenbrink Boldizsar Kovacs Tobias C. Dreher Christian Blockhaus Michael Gotzmann Norbert Klein Thomas Kuntz Dong‐In Shin Hendrik Lapp Stephanie Rosenkaimer Mohammad Abumayyaleh Nazha Hamdani Ardan Muammer Saguner Jacqueline Kowitz Julia W. Erath Firat Duru Andreas Mügge Ibrahim Akin Assem Aweimer Thomas Beiert |
| author_facet | Ibrahim El‐Battrawy Katharina Koepsel David Tenbrink Boldizsar Kovacs Tobias C. Dreher Christian Blockhaus Michael Gotzmann Norbert Klein Thomas Kuntz Dong‐In Shin Hendrik Lapp Stephanie Rosenkaimer Mohammad Abumayyaleh Nazha Hamdani Ardan Muammer Saguner Jacqueline Kowitz Julia W. Erath Firat Duru Andreas Mügge Ibrahim Akin Assem Aweimer Thomas Beiert |
| author_sort | Ibrahim El‐Battrawy |
| collection | DOAJ |
| description | Background Data on the use of the wearable cardioverter‐defibrillator (WCD) among patients with myocarditis remain sparse. Consequently, evidence for guideline recommendations in this patient population is lacking. Methods and Results In total, 1596 consecutive patients were included in a multicenter registry from 8 European centers, with 124 patients (8%) having received the WCD due to myocarditis and reduced left ventricular ejection fraction or prior ventricular tachyarrhythmia. The mean age was 51.6±16.3 years, with 74% being male. Patients were discharged after index hospitalization on heart failure medication: Angiotensin‐converting enzyme inhibitors (62.5%), angiotensin‐receptor‐neprilysin inhibitor (22.9%), aldosterone‐antagonists (51%), or beta blockers (91.4%). The initial median left ventricular ejection fraction was 30% (22%–45%) and increased to 48% (39%–55%) over long‐term follow‐up (P<0.001). The median BNP (brain natriuretic peptide) level at baseline was 1702 pg/mL (565–3748) and decreased to 188 pg/mL (26–348) over long‐term follow‐up (P=0.022). The mean wear time was 79.7±52.1 days and 21.0±4.9 hours per day. Arrhythmic event rates documented by the WCD were 9.7% for nonsustained ventricular tachycardia, 6.5% for sustained ventricular tachycardia, and 0% for ventricular fibrillation. Subsequently, 2.4% of patients experienced an appropriate WCD shock. The rate of inappropriate WCD shocks was 0.8%. All 3 patients with appropriate WCD shock had experienced ventricular tachycardia/ventricular fibrillation before WCD prescription, with only 1 patient showing a left ventricular ejection fraction <35%. Conclusions Patients with myocarditis and risk for occurrence of ventricular tachyarrhythmia may benefit from WCD use. Prior ventricular arrhythmia might appear as a better risk predictor than a reduced left ventricular ejection fraction <35% in this population. |
| first_indexed | 2024-03-11T11:38:58Z |
| format | Article |
| id | doaj.art-c3e740e36dfc421ebaa3be5e8a027544 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-11T11:38:58Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c3e740e36dfc421ebaa3be5e8a0275442023-11-10T10:23:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-09-01121810.1161/JAHA.123.030615Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter RegistryIbrahim El‐Battrawy0Katharina Koepsel1David Tenbrink2Boldizsar Kovacs3Tobias C. Dreher4Christian Blockhaus5Michael Gotzmann6Norbert Klein7Thomas Kuntz8Dong‐In Shin9Hendrik Lapp10Stephanie Rosenkaimer11Mohammad Abumayyaleh12Nazha Hamdani13Ardan Muammer Saguner14Jacqueline Kowitz15Julia W. Erath16Firat Duru17Andreas Mügge18Ibrahim Akin19Assem Aweimer20Thomas Beiert21Department of Cardiology and Angiology Bergmannsheil University Hospital, Ruhr University of Bochum Bochum GermanyDepartment of Cardiology and Angiology Bergmannsheil University Hospital, Ruhr University of Bochum Bochum GermanyDepartment of Cardiology and Angiology Bergmannsheil University Hospital, Ruhr University of Bochum Bochum GermanyDepartment of Cardiology University Heart Center, University Hospital Zurich Zürich SwitzerlandDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University Mannheim GermanyDepartment of Cardiology Heart Centre Niederrhein, Helios Clinic Krefeld Krefeld GermanyCardiology and Rhythmology University Hospital St. Josef‐Hospital Bochum, Ruhr University Bochum Bochum GermanyDepartment of Cardiology, Angiology and Internal Intensive‐Care Medicine Klinikum St. Georg gGmbH Leipzig Leipzig GermanyDepartment of Cardiology, Angiology and Internal Intensive‐Care Medicine Klinikum St. Georg gGmbH Leipzig Leipzig GermanyDepartment of Cardiology Heart Centre Niederrhein, Helios Clinic Krefeld Krefeld GermanyDepartment of Internal Medicine II, Heart Center Bonn University Hospital Bonn Bonn GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University Mannheim GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University Mannheim GermanyDepartment of Molecular and Experimental Cardiology Institut für Forschung und Lehre (IFL), Ruhr University Bochum Bochum GermanyDepartment of Cardiology University Heart Center, University Hospital Zurich Zürich SwitzerlandDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University Mannheim GermanyDepartment of Cardiology, Frankfurt University Hospital Goethe University Frankfurt am Main GermanyDepartment of Cardiology University Heart Center, University Hospital Zurich Zürich SwitzerlandDepartment of Cardiology and Angiology Bergmannsheil University Hospital, Ruhr University of Bochum Bochum GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University Mannheim GermanyDepartment of Cardiology and Angiology Bergmannsheil University Hospital, Ruhr University of Bochum Bochum GermanyDepartment of Internal Medicine II, Heart Center Bonn University Hospital Bonn Bonn GermanyBackground Data on the use of the wearable cardioverter‐defibrillator (WCD) among patients with myocarditis remain sparse. Consequently, evidence for guideline recommendations in this patient population is lacking. Methods and Results In total, 1596 consecutive patients were included in a multicenter registry from 8 European centers, with 124 patients (8%) having received the WCD due to myocarditis and reduced left ventricular ejection fraction or prior ventricular tachyarrhythmia. The mean age was 51.6±16.3 years, with 74% being male. Patients were discharged after index hospitalization on heart failure medication: Angiotensin‐converting enzyme inhibitors (62.5%), angiotensin‐receptor‐neprilysin inhibitor (22.9%), aldosterone‐antagonists (51%), or beta blockers (91.4%). The initial median left ventricular ejection fraction was 30% (22%–45%) and increased to 48% (39%–55%) over long‐term follow‐up (P<0.001). The median BNP (brain natriuretic peptide) level at baseline was 1702 pg/mL (565–3748) and decreased to 188 pg/mL (26–348) over long‐term follow‐up (P=0.022). The mean wear time was 79.7±52.1 days and 21.0±4.9 hours per day. Arrhythmic event rates documented by the WCD were 9.7% for nonsustained ventricular tachycardia, 6.5% for sustained ventricular tachycardia, and 0% for ventricular fibrillation. Subsequently, 2.4% of patients experienced an appropriate WCD shock. The rate of inappropriate WCD shocks was 0.8%. All 3 patients with appropriate WCD shock had experienced ventricular tachycardia/ventricular fibrillation before WCD prescription, with only 1 patient showing a left ventricular ejection fraction <35%. Conclusions Patients with myocarditis and risk for occurrence of ventricular tachyarrhythmia may benefit from WCD use. Prior ventricular arrhythmia might appear as a better risk predictor than a reduced left ventricular ejection fraction <35% in this population.https://www.ahajournals.org/doi/10.1161/JAHA.123.030615myocarditissudden cardiac deathventricular tachycardiawearable cardioverter‐defibrillator |
| spellingShingle | Ibrahim El‐Battrawy Katharina Koepsel David Tenbrink Boldizsar Kovacs Tobias C. Dreher Christian Blockhaus Michael Gotzmann Norbert Klein Thomas Kuntz Dong‐In Shin Hendrik Lapp Stephanie Rosenkaimer Mohammad Abumayyaleh Nazha Hamdani Ardan Muammer Saguner Jacqueline Kowitz Julia W. Erath Firat Duru Andreas Mügge Ibrahim Akin Assem Aweimer Thomas Beiert Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease myocarditis sudden cardiac death ventricular tachycardia wearable cardioverter‐defibrillator |
| title | Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry |
| title_full | Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry |
| title_fullStr | Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry |
| title_full_unstemmed | Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry |
| title_short | Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry |
| title_sort | use of the wearable cardioverter defibrillator among patients with myocarditis and reduced ejection fraction or ventricular tachyarrhythmia data from a multicenter registry |
| topic | myocarditis sudden cardiac death ventricular tachycardia wearable cardioverter‐defibrillator |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.030615 |
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