title: The use of wearable cardioverter-defibrillators in Europe: results of the European Heart Rhythm Association survey.
abstract: The aim of this European Heart Rhythm Association (EHRA) survey was to collect data on the use of wearable cardioverter-defibrillators (WCDs) among members of the EHRA electrophysiology research network. Of the 50 responding centres, 23 (47%) reported WCD use. Devices were fully reimbursed in 17 (43.6%) of 39 respondents, and partially reimbursed in 3 centres (7.7%). Eleven out of 20 centres (55%) reported acceptable patients' compliance (WCD worn for >90% of time). The most common indications for WCD (8 out of 10 centres; 80%) were covering the period until re-implantation of ICD explanted due to infection, in patients with left ventricular impairment due to myocarditis or recent myocardial infarction and those awaiting heart transplantation. Patient life expectancy of <12 months and poor compliance were the most commonly reported contraindications for WCD (24 of 46 centres, 52.2%). The major problems encountered by physicians managing patients with WCD were costs (8 of 18 centres, 44.4%), non-compliance, and incorrect use of WCD. Four of 17 centres (23.5%) reported inappropriate WCD activations in <5% of patients. The first shock success rate in terminating ventricular arrhythmias was 95-100% in 6 of 15 centres (40%), 85-95% in 4 (26.7%), 75-85% in 2 (13.3%), and <75% in 3 centres (20%). The survey has shown that the use of WCD in Europe is still restricted and depends on reimbursement. Patients' compliance remains low. Heterogeneity of indications for WCD among centres underscores the need for further research and a better definition of indications for WCD in specific patient groups.
authors: Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Medical University, Silesian Center for Heart Disease, Curie-Skłodowskiej 9, Zabrze 41-800, Poland radle@poczta.onet.pl.
authors: Radosław
authors: R
authors: Lenarczyk
authors: School of Medicine, Belgrade University, Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Tatjana S
authors: TS
authors: Potpara
authors: Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Kristina H
authors: KH
authors: Haugaa
authors: Cardiology Department, Ramón y Cajal Hospital, Madrid 28034, Spain.
authors: Antonio
authors: A
authors: Hernández-Madrid
authors: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala 75185, Sweden.
authors: Elena
authors: E
authors: Sciaraffia
authors: Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany.
authors: Nikolaos
authors: N
authors: Dagres
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control*; D047548:Defibrillators / Q000706:statistics & numerical data*; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation* / Q000401:mortality / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015995:Prevalence; D015996:Survival Rate; D014600:Utilization Review
keywords: EHRA survey; EP wire; Heart failure; Implantable cardioverter-defibrillator; Prevention; Sudden cardiac death; Ventricular arrhythmias; Wearable cardioverter-defibrillator