Experience with the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death
Background—The study evaluated the wearable cardioverter defibrillator (WCD) for use and effectiveness in preventing sudden death due to ventricular tachyarrhythmia (VT) or fibrillation (VF).
Methods—From April 2010 through October 2013 6,043 German WCD patients (median age 57 years, male 78.5%) were recruited from 404 German centers. De-identified German patient data were used for a retrospective, non-randomized analysis.
Results—There were 94 (1.6%) patients treated by the WCD in response to VT/VF. The incidence rate and 95% CI was 8.4 [6.8, 10.2] per 100 patient years. Patients with implantable cardioverter-defibrillator (ICD) explantation had an incidence rate of 19.3 [12.2, 29.0] per 100 patient years. In contrast, an incidence rate of 8.2 [6.4, 10.3] was observed in the remaining cardiac diagnosis groups including dilated cardiomyopathy (DCM), myocarditis, as well as ischemic and non-ischemic cardiomyopathies (NICM). Among 120 shocked patients 112 (93%) survived 24 hour post-treatment while asystole was observed in 2 (0.03%) patients with 1 resulting death.
Conclusions—This large cohort represents the first nation-wide evaluation of WCD use in patients outside the US healthcare system and confirms the overall value of the WCD in German treatment pathways.
- wearable cardioverter defibrillator
- ventricular arrhythmia
- heart failure
- arrhythmia (heart rhythm disorders)
- sudden cardiac death
- Received August 20, 2015.
- Revision received June 16, 2016.
- Accepted June 27, 2016.
Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.