Wenn die Weste einige Nummern zu groß ist: Sinn und Unsinn der LifeVest bei Postinfarktpatienten

Zusammenfassung

Die LifeVest ist eine tragbare Kardioverter-Defibrillator-Weste (WCD), die eine zeitlich limitierte diagnostische und therapeutische, nicht invasive Option für Patienten mit einem hohen Risiko für den plötzlichen Herztod (PHT) auf dem Boden von lebensbedrohlichen anhaltenden ventrikulären Tachyarrhythmien darstellt. Hierbei hat sich die LifeVest sowohl bei Patienten mit transienter höhergradiger linksventrikulärer Dysfunktion als auch bei Patienten zur Überbrückung bis zur endgültigen Versorgung mit einem implantierbaren Kardioverter-Defibrillator (ICD) in der klinischen Praxis etabliert. Unklar waren bislang die Effektivität und der zusätzliche Benefit der WCD innerhalb der ersten Wochen nach stattgehabtem Myokardinfarkt bei Patienten mit reduzierter linksventrikulärer Pumpfunktion. In der prospektiven, randomisierten und kontrollierten VEST-Studie konnte kein Zusatznutzen der WCD bezüglich der Verhinderung des PHT in dieser Patientengruppe aufgezeigt werden.

Abstract

The LifeVest, a wearable cardioverter defibrillator vest (WCD), is a temporary noninvasive diagnostic and therapeutic option for patients at high risk for sudden cardiac death (SCD) and life threatening sustained ventricular tachyarrhythmias. The LifeVest has been established in both, patients with transient significant left ventricular dysfunction and for bridging of patients before definite implantation of an implantable cardioverter defibrillator (ICD). Thus far, efficacy and additional benefit of the WCD in the early weeks in patients with significantly reduced left ventricular function after acute myocardial infarction has not been investigated. The prospective, randomized and controlled VEST trial revealed no additional benefit of the WCD regarding prevention of SCD in this patient population.

Schlüsselwörter

plötzlicher Herztod (PHT) - Postinfarktphase - tragbarer Kardioverter-Defibrillator (WCD)

Key words

sudden cardiac death (SCD) - post-infarction period - wearable cardioverter defibrillator vest (WCD)

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