Risk for ventricular fibrillation in peripartum cardiomyopathy with severely reduced left ventricular function-value of the wearable cardioverter/defibrillator

Introduction: The wearable cardioverter defibrillator (WCD) has been used to protect AMI patients with reduced LVEF (≤35%) until ICD evaluation is recommended. The rate of EF improvement (e.g. EF>35%) over the initial 8-12 weeks after AMI has not been reported. METHODS: The manufacturer-maintained registry was searched for AMI patients who received a WCD shock for VT/VF between 05/2008 and 02/2013. The treated group was matched (1: ~4) with event-free WCD patients by ICD-9 code (410.*), gender, age and prescription date. Chart notes were reviewed for clinical characteristics. Follow-up was assessed through the registry and Social Security Death Master File. RESULTS: There were 992 (age=63±12, female=20.2%) AMI patients included in the final analysis, 206 treated by WCD and 786 event-free patients. Median follow-up was 334 days. Mean length of WCD use was 67±506 (median=38) days. Subgroup clinical characteristics are presented in Table 1. In the event-free group, 289 (38.9%) patients showed EF improvement to >35%. Nine (4.5%) in the treated group continued wearing the WCD until EF recovery, while 125 (60.7%) received ICD. Absence of recorded heart failure and/or diabetes were associated with LVEF recovery (p<.0001). CONCLUSION: In our study, almost 40% of AMI patients with initial EF ≤35% had EF improvement in two months. The EF recovery group had lower rates of heart failure and diabetes. WCD allows time for left ventricular function recovery in low EF post MI patients, optimizing ICD implantation decisions.

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Effective treatment of electrical storm by a wearable cardioverter defibrillator in a patient with severely impaired left ventricular function after myocardial infarction: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02833-2 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Henrike Andresen ◽

B. Sasko ◽

D. Patschan ◽

N. Pagonas ◽

O. Ritter

Keyword(s):

Myocardial Infarction ◽

Sudden Cardiac Death ◽

Left Ventricular Function ◽

Ventricular Function ◽

Cardiac Death ◽

Left Ventricular ◽

Electrical Storm ◽

Impaired Left Ventricular Function ◽

Cardioverter Defibrillator ◽

Wearable Cardioverter Defibrillator

Abstract Background The implantation of cardioverter defibrillators (ICDs) is an established therapy in the prevention of sudden cardiac death in patients with systolic dysfunction after myocardial infarction. To avoid immediate implantation of an ICD, wearable cardioverter defibrillator vests (WCD) can be used to protect patients against malignant rhythm disorders, while at the same time drug-based heart failure therapy has to be initiated. This drug therapy can improve left ventricular ejection fraction and primary prophylactic cardioverter defibrillator implantation may not be necessary. However, the recent Vest Prevention of Early Sudden Death Trial (VEST) questioned the regular use of the WCD in this setting. Case presentation A 47-year-old Caucasian man with severely impaired left ventricular function early after myocardial infarction was prescribed a WCD as primary prophylaxis to prevent sudden cardiac death. Seven days after the patient was supplied with a WCD, the patient suffered from an electrical storm with recurrent ventricular tachycardia (VT), which was successfully terminated 17 times by the WCD. On coronary angiography, the formerly infarct-related right coronary artery had TIMI (Thrombolysis in Myocardial Ischemia Trial) III flow, and a remaining stenosis in the left anterior descending artery (LAD) was stented, which did not stop recurrent VT. In the electrophysiology (EP) study, a focus was mapped in the left inferior ventricle, which was ablated. This stopped the VT. A second radio-frequency (RF) ablation in the same area was necessary after 14 days. Finally, a permanent cardioverter defibrillator was implanted. Conclusion We report the case of a patient who survived recurrent episodes of VT early after myocardial infarction by effective defibrillation with a WCD. The WCD is a useful device to bridge time until a final decision for implantation of a defibrillator.

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Rationale and design of a randomized, controlled multicentre clinical trial to evaluate the effect of bromocriptine on left ventricular function in women with peripartum cardiomyopathy

Clinical Research in Cardiology ◽

10.1007/s00392-015-0869-5 ◽

2015 ◽

Vol 104 (11) ◽

pp. 911-917 ◽

Cited By ~ 36

Author(s):

Arash Haghikia ◽

Edith Podewski ◽

Dominik Berliner ◽

Kristina Sonnenschein ◽

Dieter Fischer ◽

...

Keyword(s):

Clinical Trial ◽

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Multicentre Clinical Trial ◽

Randomized Controlled

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Peripartum cardiomyopathy: analysis of clinical outcome, left ventricular function, plasma levels of cytokines and Fas/APO-1

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(99)00624-5 ◽

2000 ◽

Vol 35 (3) ◽

pp. 701-705 ◽

Cited By ~ 170

Author(s):

Karen Sliwa ◽

Daniel Skudicky ◽

Anette Bergemann ◽

Geoffrey Candy ◽

Adrian Puren ◽

...

Keyword(s):

Clinical Outcome ◽

Left Ventricular Function ◽

Ventricular Function ◽

Plasma Levels ◽

Left Ventricular ◽

Peripartum Cardiomyopathy

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Rest left ventricular function and contractile reserve by dobutamine stress echocardiography in peripartum cardiomyopathy

Revista Portuguesa de Cardiologia (English Edition) ◽

10.1016/j.repce.2012.04.002 ◽

2012 ◽

Vol 31 (4) ◽

pp. 287-293

Author(s):

Marcia M. Barbosa ◽

Cláudia M.V. Freire ◽

Bruno Ramos Nascimento ◽

Carlos E. Rochitte ◽

Marly C. Silva ◽

...

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Stress Echocardiography ◽

Dobutamine Stress Echocardiography ◽

Dobutamine Stress ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Contractile Reserve

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Cardiac resynchronisation therapy: pacemaker versus internal cardioverter-defibrillator in patients with impaired left ventricular function

Heart ◽

10.1136/heartjnl-2014-305537 ◽

2014 ◽

Vol 100 (10) ◽

pp. 794-799 ◽

Cited By ~ 20

Author(s):

Khang-Li Looi ◽

Parag R Gajendragadkar ◽

Fakhar Z Khan ◽

Maros Elsik ◽

David A Begley ◽

...

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Cardiac Resynchronisation Therapy ◽

Left Ventricular ◽

Impaired Left Ventricular Function ◽

Cardioverter Defibrillator ◽

Cardiac Resynchronisation ◽

Resynchronisation Therapy ◽

Internal Cardioverter Defibrillator

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Peripartum cardiomyopathy: case report

Acta medica Lituanica ◽

10.6001/actamedica.v19i3.2455 ◽

2012 ◽

Vol 19 (3) ◽

pp. 224-227

Author(s):

Andrius Macas ◽

Kęstutis Rimaitis ◽

Giedrė Bakšytė ◽

Laura Šilinskytė

Keyword(s):

Heart Failure ◽

Left Ventricular Function ◽

Ventricular Function ◽

Young Women ◽

Asymptomatic Patient ◽

Complete Recovery ◽

Fetal Outcome ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Maternal Outcomes

Peripartum cardiomyopathy is an unusual and uncommon form of dilat ed cardiomyopathy that is often fatal to young women, the cause of which is unknown. Diagnostics is difficult and requires vigilance. The treatment does not differ from other forms of heart failure. Fetal outcome, however, is quite good. Maternal outcomes depend on 2–6 months recovery of the left ventricular function. We describe a previously asymptomatic patient who presented with pulmonary edema one day after caesarean section. In this case the solution was favorable to the patient. Complete recovery of the left ventricular function happened earlier than indicated in litera ture.

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