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EFFECTIVENESS OF WEARABLE DEFIBRILLATORS: SYSTEMATIC REVIEW AND QUALITY OF EVIDENCE

Published online by Cambridge University Press:  04 June 2014

Jennifer Uyei
Affiliation:
Division of Comparative Effectiveness and Decision Sciences, Department of Population Health, New York University School of Medicine
R. Scott Braithwaite
Affiliation:
Division of Comparative Effectiveness and Decision Sciences, Department of Population Health, New York University School of Medicine

Abstract

Objectives: The objectives of this systematic literature review were to identify all published literature on wearable defibrillators, assess the wearable defibrillator's efficacy and effectiveness in general and among specific patient groups, including post-myocardial infarction, post coronary artery bypass grafting or percutaneous coronary intervention, non-ischemic cardiomyopathy, and ischemic cardiomyopathy, and to evaluate the quality of evidence.

Methods: The search and synthesis was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation and the Newcastle Ottawa Scale.

Results: A total of thirty-six articles and conference abstracts from thirty-three studies were included in the review. It appears that wearable defibrillator use compared with no defibrillator use reduces the chance of ventricular tachycardia and ventricular fibrillation (VT/VF) associated deaths by an absolute risk reduction of approximately 1 percent, achieved by averting approximately 4/5th of all VT/VF associated deaths. The quality of evidence was low to very low quality, such that our confidence in the reported estimates is weak.

Conclusions: To validate beneficial results, further investigation using robust study designs conducted by independent researchers is warranted.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

1. American Heart Association. About cardiac arrest. 2011. http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About-Cardiac-Arrest_UCM_307905_Article.jsp (accessed January 22, 2013).Google Scholar
2. Mayo Clinic. Sudden cardiac arrest causes. Mayo Clinic; 2012. http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764/DSECTION=causes (accessed January 22, 2013)Google Scholar
3. Mayo Clinic. Ventricular tachycardia. Mayo Clinic; 2013. Available from: http://www.mayoclinic.org/ventricular-tachycardia/ (accessed January 22, 2013)Google Scholar
4. Travers, AH, Rea, TD, Bobrow, BJ, et al. Part 4: CPR overview: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. [Review]. 2010;122 (Suppl 3):S676684.Google Scholar
5. Holmberg, M, Holmberg, S, Herlitz, J. Incidence, duration and survival of ventricular fibrillation in out-of-hospital cardiac arrest patients in sweden. Resuscitation. 2000;44:717.Google Scholar
6. Zishiri, E, Chung, MK. The role of the wearable coardioverter-defibrillator in contemporary clinical practice. J Innov Cardiac Rhythm Manage. 2011;2:307316.Google Scholar
7. Zoll Lifecor Corporation. LifeVest System WCD 3100 operator's manual. Pittsburh, PA: Zoll Lifecor Corporation; 2006.Google Scholar
8. Epstein, AE, DiMarco, JP, Ellenbogen, KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-based therapy of cardiac rhythm abnormalities: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;51:e162.Google Scholar
9. American College of Cardiology, American Heart Association Task Force, European Society of Cardiology Committee for Practice Guidelines. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac arrest. Europace. 2006;8:746837.Google Scholar
10. Gronda, E, Bourge, RC, Costanzo, MR, et al. Heart rhythm considerations in heart transplant candidates and considerations for ventricular assist devices: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates–2006. J Heart Lung Transplant. 2006;25:10431056.Google Scholar
11. Hayes Inc. LifeVest System (Asahi Kasei Corp.) Wearable cardiac defibrillator for prevention of sudden cardiac arrest. Lansdale, PA: Hayes Inc; 2012.Google Scholar
12. Moher, D, Altman, DG, Liberati, A, Tetzlaff, J. PRISMA statement. Epidemiology. [Letter]. 2011;22:128; author reply.Google Scholar
13. Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.Google Scholar
14. American College of Cardiology Foundation, American Heart Association, European Society of Cardiology. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Europace. 2006;8:746837.Google Scholar
15. Balshem, H, Helfand, M, Schunemann, HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64:401406.Google Scholar
16. Wells, GA, Shea, B, O'Connell, D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2008. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed January 7, 2013).Google Scholar
17. Saltzberg, MT, Szymkiewicz, S, Bianco, NR. Characteristics and outcomes of peripartum versus nonperipartum cardiomyopathy in women using a wearable cardiac defibrillator. J Card Fail. 2012;18:2127.Google Scholar
18. Zishiri, ET, Cronin, E, Williams, S, et al. Use of the wearable cardioverter defibrillator and survival after coronary artery revascularization in patients with left ventricular dysfunction. Circulation. 2011;22:1.Google Scholar
19. Chung, MK, Szymkiewicz, SJ, Shao, M, et al. Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival. J Am Coll Cardiol. 2010;56:194203.Google Scholar
20. Bianco, NR, Szymkiewicz, SJ. Long-term mortality risk in post-myocardial infarct patients resuscitated by a wearable cardiac defibrillator. J Am Coll Cardiol. 2011;5:E39.Google Scholar
21. Deering, TF, Curwin, JH, Glad, JAM. Wearable defibrillator Use after myocardial infarction: Results of the WAMI registry. J Am Coll Cardiol. 2011;5:E142.Google Scholar
22. Epstein, AE, Haines, D, Bianco, N, Szymkiewicz, S. Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post MI. J Am Coll Cardiol. 2012;1:E644.Google Scholar
23. Karia, D, Bianco, N, Szymkiewicz, S. Newly diagnosed non-ischemic cardiomyopathy patients bridged with the wearable cardioverter defibrillator. Eur J Heart Fail Suppl. 2010;9:S192.Google Scholar
24. Karia, D, Bianco, N, Szymkiewicz, S. Rate of LV systolic function recovery in cardiomyopathy patients prescribed wearable cardiac defibrillator. Eur J Heart Fail Suppl. 2011;10:S40.Google Scholar
25. Reek, S, Geller, JC, Meltendorf, U, et al. Clinical efficacy of a wearable defibrillator in acutely terminating episodes of ventricular fibrillation using biphasic shocks. Pacing Clin Electrophysiol. 2003;26:20162022.Google Scholar
26. Mitrani, RD, McArdle, A, Slane, M, Cogan, J. Use of automatic wearable defibrillator in an uninsured patient population. Heart Rhythm. 2010;1:S309310.Google Scholar
27. Grimes, DA, Schulz, KF. Cohort studies: marching towards outcomes. Lancet. 2002;359:341345.Google Scholar
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