Abstract 20724: Efficacy and Cost-Effectiveness of Wearable Cardioverter Defibrillator as a Lifesaving-Bridge Therapy for Decision in High Risk Patients of Sudden Arrhythmic Death : 3-Year Follow-Up Result
Introduction: The wearable cardioverter-defibrillator (WCD) is an external defibrillator that automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander. This study was designed to determine patient compliance and effectiveness of WCD in terminating tachyarrhythmias in patients at high risk for sudden cardiac death (SCD). This study was designed to determine the efficacy and cost-effectiveness of the WCD in terminating tachyarrhythmias in patients at high risk for SCD.
Hypothesis: WCD is a safe and beneficial device for patients at high risk for SCD, and provides superior cost-effectiveness.
Methods: This study was conducted on all WCD patients who were at high risk for SCD but did not meet the implantation-eligibility criteria for implantable cardioverter-defibrillator (ICD). All patients were followed-up at the University Hospital of Bonn in Germany.
Results: Sixty-six patients (age 66 (51-78), males 74%, follow-up period 36 (30-47) months) were enrolled. Of those, 24 (36%) were early post-myocardial infarction patients. Thirty-one patients (47%) used a WCD for secondary prevention for SCD. The mean duration of use was 55 (24-85) days. A total of 3 patients (5.0%) were shocked by a WCD. No patients experienced an inappropriate treatment and died during the WCD therapy period. An ICD was implanted in 37 patients (56%) and subcutaneous ICD was implanted in only one young patient (1.5%) after the WCD therapies. Of 28 patients (42%), the use of WCD contributed to the prevention of an unnecessary ICD implantations. In terms of the Japanese medical economic impact, WCD therapy was able to save 8,273 dollars (76,916 yen) per patient. After WCD therapy, 3 patients with an ICD died; however, no death occurred in patients without an ICD.
Conclusions: WCD is a safe and beneficial device for patients at high risk for SCD, who are not clear candidates for an ICD, and provides superior cost-effectiveness.
Author Disclosures: Y. Kondo: Research Grant; Significant; St. Jude Medical, Biotronik Japan. M. Ueda: None. Y. Kobayashi: Research Grant; Significant; St. Jude Medical, Biotronik Japan, Boston Scientific.
- © 2016 by American Heart Association, Inc.