Playing it close to the VEST and the clinical guidelines: Clinical guideline compliance in HFrEF patients-Role of WCD
| Autor: | Samuel F. Sears, Emily Keltner, Amelia E. Roebuck, Michael J. Mirro |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Adrenergic beta-Antagonists Electric Countershock Angiotensin-Converting Enzyme Inhibitors 030204 cardiovascular system & hematology Sudden cardiac death 03 medical and health sciences Wearable Electronic Devices 0302 clinical medicine medicine Humans 030212 general & internal medicine Aged Mineralocorticoid Receptor Antagonists Retrospective Studies Heart Failure Ejection fraction business.industry Medical record Stroke Volume General Medicine Middle Aged medicine.disease Implantable cardioverter-defibrillator Treatment Outcome Echocardiography Heart failure Emergency medicine VEST Observational study Female Guideline Adherence Cardiology and Cardiovascular Medicine business Wearable cardioverter defibrillator |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 41(10) |
| ISSN: | 1540-8159 |
| Popis: | BACKGROUND Guideline-directed medical therapy (GDMT) for patients with heart failure with reduced ejection fraction (HFrEF) has been challenging to achieve universally. Healthcare providers who seek to achieve optimal medical therapy frequently consider either a wearable cardioverter defibrillator (WCD) or an implantable cardioverter defibrillator (ICD) as indicated. The dynamic process of communication and physician recommendations marks a setting to study the relative interdependence of medical therapies and best practice. The purpose of this study was to examine the long-term impact of the WCD on GDMT. We hypothesized the WCD serves as a "gateway" therapy, likely impacting other optimal strategies such that successful use of WCD improves GDMT adherence. METHODS Electronic medical records (EPIC) were manually reviewed to extract data elements in this observational study of 1289 HFrEF patients from 2013-2015. Data included demographics, comorbidities, and use of GDMT including an ICD use in persistently low ejection fraction (≤36%) patients after 90 days. RESULTS WCD use was significantly associated with prescribing adherence to GDMT, χ2 (1, N = 981) = 33.36, P |
| Databáze: | OpenAIRE |
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