Use of the Wearable Cardioverter Defibrillator in High-Risk Cardiac Patients: Data from the Prospective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry)
Background—Prospective data on the safety and efficacy of the wearable cardioverter defibrillator (WCD) in a real world setting are lacking. The Prospective Registry of Patients Using the Wearable Defibrillator (WEARIT-II) Registry was designed to provide real world data on the WCD as a strategy during a period of risk stratification.
Methods and Results—The WEARIT-II Registry enrolled 2000 patients with ischemic (n=805, 40%), or non-ischemic cardiomyopathy (n=927, 46%), or congenital/inherited heart disease (n=268) prescribed WCD between August 2011 and February 2014. Clinical data, arrhythmia events, implantable cardioverter defibrillator (ICD) implantation, or improvement in ejection fraction (EF) were captured. The median age was 62 years, median EF was 25%. Median WCD wear-time was 90 days, with median daily use of 22.5 hours. There were a total of 120 sustained ventricular tachyarrhythmias (VT/VF) in 41 patients, of whom 54% received appropriate WCD shock. Only 10 patients (0.5%) received inappropriate WCD therapy. The rate of sustained VT/VF by 3 months was 3% among patients with ischemic cardiomyopathy and congenital/inherited heart disease, and 1% among non-ischemic patients (p=0.02). At the end of WCD use, 840 patients (42%) were implanted with ICD. The most frequent reason not to implant ICD following WCD use was improvement in EF.
Conclusions—The WEARIT-II prospective Registry demonstrate a high rate of sustained VT/VF at 3 months in at-risk patients who are not eligible for an ICD, and suggest that the WCD can be safely used to protect patients during this time period of risk assessment.
- Wearable Cardioverter Defibrillator
- Risk Stratification
- implantable cardioverter-defibrillator
- ventricular fibrillation
- ventricular tachycardia
- sudden cardiac death
- Received January 28, 2015.
- Revision received August 5, 2015.
- Accepted August 13, 2015.