ÖKG Symposia

Published: 01 June 2022

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Overview

Full programme

Overview

In this four-part video series, we hear from Prof Clemens Steinwender (Kepler University Hospital, AT), Prof Assad Haneya (University Medical Center Schleswig-Holstein, DE) and Prof Diana Bonderman (Medical University of Vienna, AT), as they each give a different perspective on Contemporary Management of SCD High-risk Patients After an Acute Cardiovascular Event from the ÖKG Symposia, in Salzburg, Austria. 

This content is sponsored by ZOLL

Series overview

Part 1

Contemporary Management of SCD High-risk Patients After an Acute Cardiovascular Event – A Cardiological Perspective

Prof Steinwender concludes that wearing the WCD provides effective and safe protection against SCD. Both international and national cardiological societies recommend the WCD for transient SCD risk. While we have powerful drugs available to improve heart function, they take time to develop their full effect. It is therefore a matter of course for us to protect high-risk patients with a defibrillator vest in the first three months and, if necessary, beyond that, says Prof Steinwender. He observed that about 50% of patients do not require an ICD due to improvement in LVEF.

Part 2

Contemporary Management of SCD High-risk Patients After an Acute Cardiovascular Event – A Heartsurgical Perspective

The WCD allows for an extended time window to evaluate an ICD implantation. Thus, the number of primary prophylactic ICD implantations can be reduced, which prove to be no longer indicated after the ventricular restitution. A clearly structured clinical process identifies patients with a high risk of SCD and provides them with the necessary therapy in a timely manner: WCD vs. permanent ICD.

Part 3

Contemporary Management of SCD High-risk Patients After an Acute Cardiovascular Event – A Heart Insufficiency Perspective

Heart insufficiency therapy needs time. In addition to the detection and treatment of life-threatening cardiac arrhythmias, the LifeVest® supports telemonitoring and hence therapy optimization – for example, heart rate monitoring can help determine the optimal beta-blocker dosage. Via the ZOLL Patient Management (ZPM) Network, the attending physician can access current health data via telemonitoring during the WCD wearing time and thus record heart rate, physical activity and body position. Especially the heart rate is associated with a higher mortality risk.

Part 4

Discussion

Wearing compliance can be improved by a proper patient education prior to discharge with the WCD; Prof Haneya, who adds that compliance is excellent (over 23h) despite a sternotomy after CABG further supports this. The rate of inappropriate shocks was less than 1%, similar to cardiological patients. Along an improved reimbursement in Austria, the clinical need for a WCD is increasing. Telemonitoring can support the phase of uptitration to achieve optimal medical therapy. Prof Pürerfellner concludes that the data for the LifeVest® is comprehensive and convincing, the use of the WCD is established both in cardiology and in cardiac surgery.
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Faculty Biographies

Clemens Steinwender

Clemens Steinwender

Head, Department of Cardiology

Prof Steinwender was educated at the Medical University of Vienna and since 2013 is Head of the Department of Cardiology at the Kepler University Hospital in Linz, Austria.

His main scientific focus is on device therapy and ablation of arrhythmias. He has been and is involved in several clinical trials on leadless pacing, like the Micra TPS or MARVEL 2 studies.

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