Abstract 341: The Wearable Cardioverter Defibrillator Protects Older Patients from Sudden Cardiac Death
Purpose: Patients ≥65 years old are at higher risk for cardiac mortality, including sudden cardiac death (SCD), since age plays a role in the development and progression of cardiovascular diseases. However, given their higher rate of post-procedural complications and complex comorbidities, as well as poorer long-term prognosis, devices for preventing SCD such as the implantable cardioverter defibrillator (ICD) and the wearable cardioverter defibrillator (WCD) may not provide the same benefits as with younger patients. This study sought to evaluate the use and clinical outcomes of the WCD in patients ≥65 years old.
Methods: All patients who were ≥65 years old and using a WCD between 1/2005 and 3/2014 were selected from the manufacturer’s post-market database, then grouped by age decades. Indications for WCD were assessed through ICD-9 codes used in insurance claims; demographics and end of use (EOU) reasons as well as device recorded ECG and compliance were also used in the analysis. p≤0.05 was considered statistically significant.
Results: The 54,154 patients who met study criteria were divided into three groups by age: 65-74 (n=33,150), 75-84 (n=18,201), and >84 (n=2,803). Demographics and WCD indications were similar across all groups (table). There were 890 (1.6%) VT/VF events detected and treated, among which 817 (91.8%) survived. Median length of use was 47 days, 43 days and 35 days (p<0.05), while median daily use was 21.4 hours, 21.9 hours and 21.9 hours, respectively. EOU reasons, similar across all groups, included EF improvement (28.7%), ICD implantation (34.5%), death (4%), and other (32.8%).
Conclusions: WCD use in patients ≥65 years old who are at risk of SCD is similar to that reported in general WCD patients. The majority of patients either recovered or proceeded to ICD implantation after ending use.
Author Disclosures: C. Wan: Employment; Significant; ZOLL. S.J. Szymkiewicz: Employment; Significant; ZOLL.
- © 2014 by American Heart Association, Inc.