Keywords

heart failure, Kansas City cardiomyopathy questionnaire, quality of life, wearable cardioverter defibrillator

 

Authors

  1. Burch, Ashley E. PhD
  2. Colley, Byron J. MD
  3. Doring, Michael MD
  4. Gummadi, Siva MD
  5. Perings, Christian MD, PhD
  6. Robertson, Michael NP
  7. Sanchez, Robert MD
  8. Shroff, Girish MD
  9. Veltmann, Christian MD, PhD
  10. Sears, Samuel F. PhD

Abstract

Background: The patient experience of heart failure involves a multi-impact symptom response with functional limitations, psychological changes, and significant treatment burden.

 

Objective: The aim of this study was to examine the change in patient-reported outcomes in newly diagnosed patients with heart failure and reduced ejection fraction (HFrEF) prescribed a wearable cardioverter defibrillator.

 

Methods: Adults hospitalized for new-onset heart failure, due to ischemic or nonischemic cardiomyopathy, and prescribed a wearable cardioverter defibrillator within 10 days post discharge were approached for inclusion. Participants completed the Kansas City Cardiomyopathy Questionnaire at 3 time points: baseline, day 90, and day 180.

 

Results: A total of 210 patients (26% female) were included. All Kansas City Cardiomyopathy Questionnaire subscales (physical limitation, symptom frequency, quality of life, and social limitation) showed improvement from baseline to day 90 (all Ps < .001). Only quality of life continued to improve from day 90 to day 180 (P < .001). By day 90, nearly 70% of patients showed an improvement in quality of life (67.9%, n = 91), and by day 180, more than 80% (82.8%, n = 111) reported a net improvement. Five patients (3.7%) reported a net decrease, and 18 patients (13.4%) had no net change in quality of life during the 180-day period.

 

Conclusion: Patient-reported quality of life improved significantly among patients newly diagnosed with HFrEF and prescribed a wearable cardioverter defibrillator. These results suggest that pursuing guideline-directed medical therapy for HFrEF, while being protected by the wearable cardioverter defibrillator, is likely to provide symptom relief and improve quality of life.