Mortality and Costs Associated with Wearable Cardioverter-defibrillators after Acute Myocardial Infarction: A Retrospective Cohort Analysis of Medicare Claims Data.

Ventricular arrhythmias are common in the early period after myocardial infarction (MI), with the highest risk occurring in the immediate postinfarct window. The wearable cardioverter-defibrillator (WCD) has been proven to have efficacy in treating sudden cardiac arrest in patients soon after MI. However, data concerning clinical and health economic outcomes of WCD usage among Medicare patients have not been evaluated.

Long-term use of the wearable cardioverter defibrillator in patients with explanted ICD.

Objectives: To evaluate the effectiveness of wearable cardioverter defibrillator (WCD) use in protecting patients from sudden cardiac arrest (SCA) while they were treated in nonhospital settings until re-implantation of an Implantable cardioverter-defibrillator (ICD) was feasible. We sought to determine whether the WCD could be successfully utilized long term (≥1 year) after ICD extraction in patients at continued risk of SCD in which ICD re-implantation was not practical.

Background: ICDs have proven to improve mortality in patients for both secondary and primary prevention of SCA.

The impact of body mass index on the wearable cardioverter defibrillator shock efficacy and patient wear time.

Background: The impact of body mass index (BMI) on the shock efficacy and patient adherence among patients using a wearable cardioverter defibrillator (WCD) is unknown.

Methods: Patients prescribed the WCD between January 1, 2008 and June 1, 2013, who experienced at least one episode of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and who received appropriate WCD therapy, were identified within a registry maintained by the manufacturer for regulatory, reimbursement, and administrative purposes. The registry contained patients' Body Mass Index (BMI) which was categorized as normal (18.

Study of the wearable cardioverter defibrillator in advanced heart-failure patients (SWIFT).

Introduction: The wearable cardioverter defibrillator (WCD) may allow stabilization until reassessment for an implantable cardioverter defibrillator (ICD) among high-risk heart failure (HF) patients. However, there are limited data on the WCD benefit in the acute decompensated HF setting.

Methods And Results: The Study of the Wearable Cardioverter Defibrillator in Advanced Heart Failure Patients (SWIFT) was a prospective clinical trial carried out at two medical centers.

Benefit of the Wearable Cardioverter-Defibrillator in Protecting Patients After Implantable-Cardioverter Defibrillator Explant: Results From the National Registry.

Objectives: This study reports on the time course of reimplantation and benefits of the wearable cardioverter-defibrillator (WCD) in patients post implantable cardioverter-defibrillator (ICD) explantation.

Background: The WCD is used to treat patients at high risk for ventricular tachycardia (VT) and ventricular fibrillation (VF), including patients with ICD-related infections who undergo device removal and cannot be immediately reimplanted.

Methods: This retrospective study included consecutive patients from 2002 to 2014 who underwent ICD removal because of device-related infection and were prescribed a WCD.

National experience with long-term use of the wearable cardioverter defibrillator in patients with cardiomyopathy.

Purpose: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF).

Methods: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use.

Experience With the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death.

Background: This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation.

Methods: From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers.

Wearable cardioverter-defibrillator as a bridge to cardiac transplantation: A national database analysis.

Background: Life-threatening ventricular arrhythmias (VAs) and sudden cardiac death (SCD) are common in patients awaiting heart transplantation (HT), and the implantable cardioverter-defibrillator (ICD) is often used for primary prevention in this setting. Use of ICDs in these patients is not without risks and is sometimes contraindicated. The wearable cardioverter-defibrillator (WCD) may be a reasonable alternative to bridge the period of risk leading up to HT.

Sudden cardiac arrest in hemodialysis patients with wearable cardioverter defibrillator.

Background: The survival outcome following a sudden cardiac arrest (SCA) in hemodialysis (HD) patients is poor regardless of whether an event takes place in or out of a dialysis center. The characteristics of SCA and post-SCA survival with HD patients using a wearable cardioverter defibrillator (WCD) are unknown.

Methods: All HD patients who were prescribed a WCD between 2004 and 2011 and experienced at least one SCA event were included in this study.

Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.

Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest.

Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post-myocardial infarction.

Objectives: The aim of this study was to describe usage of the wearable cardioverter-defibrillator (WCD) during mandated waiting periods following myocardial infarction (MI) for patients perceived to be at high risk for sudden cardiac arrest (SCA).

Background: Current device guidelines and insurance coverage require waiting periods of either 40 days or 3 months before implanting a cardioverter-defibrillator post-myocardial infarction (MI), depending on whether or not acute revascularization was undertaken.

Methods: We assessed characteristics of and outcomes for patients who had a WCD prescribed in the first 3 months post-MI.

Early risk of mortality after coronary artery revascularization in patients with left ventricular dysfunction and potential role of the wearable cardioverter defibrillator.

Background: Implantation of implantable cardioverter defibrillator for prevention of sudden cardiac death is deferred for 90 days after coronary revascularization, but mortality may be highest early after cardiac procedures in patients with ventricular dysfunction. We determined mortality risk in postrevascularization patients with left ventricular ejection fraction ≤35% and compared survival with those discharged with a wearable cardioverter defibrillator (WCD).

Methods And Results: Hospital survivors after surgical (coronary artery bypass graft surgery) or percutaneous (percutaneous coronary intervention [PCI]) revascularization with left ventricular ejection fraction ≤35% were included from Cleveland Clinic and national WCD registries.

Wearable defibrillator use in heart failure (WIF): results of a prospective registry.

Background: Heart failure (HF) patients have a high risk of death, and implantable cardioverter defibrillators (ICDs) are effective in preventing sudden cardiac death (SCD). However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD.

Characteristics and outcomes of peripartum versus nonperipartum cardiomyopathy in women using a wearable cardiac defibrillator.

Background: Peripartum cardiomyopathy (PPCM) mortality rates vary between 2% and 56%, with half occurring ≤12 weeks'; postpartum. Although risk factors for PPCM have been identified, predicting sudden cardiac death among PPCM patients remains difficult. This study describes the characteristics and outcomes of PPCM patients and controls referred for a wearable cardioverter defibrillator (WCD).

Wearable defibrillator in congenital structural heart disease and inherited arrhythmias.

Patients with congenital structural heart disease (CSHD) and inherited arrhythmias (IAs) are at high risk of ventricular tachyarrhythmias and sudden cardiac death. The present study was designed to evaluate the short- and long-term outcomes of patients with CSHD and IA who received a wearable cardioverter-defibrillator (WCD) for the prevention of sudden cardiac death. The study population included 162 patients with CSHD (n = 43) and IA (n = 119) who were prospectively followed up in a nationwide registry from 2005 to 2010.

Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival.

Objectives: The purpose of this study was to determine patient compliance and effectiveness of antiarrhythmic treatment by the wearable cardioverter-defibrillator (WCD).

Background: Effectiveness of the WCD for prevention of sudden death is dependent on event type, patient compliance, and appropriate management of ventricular tachycardia/ventricular fibrillation (VT/VF).

Methods: Compliance and events were recorded in a nationwide registry of post-market release WCDs.

The Wearable Cardioverter Defibrillator-Bridge to the Implantable Defibrillator.

The wearable cardioverter defibrillator (WCD) was introduced into clinical practice about 8 years ago as an alternative approach to protect patients with a temporary high risk of sudden arrhythmic death. The WCD has the characteristics of an implantable defibrillator (ICD) but does not need to be implanted, and it has similarities with an external defibrillator, but does not require a bystander to apply lifesaving shocks when necessary. Based on current clinical experience, the WCD is not an alternative to the ICD, but a device that will contribute to better selection of patients for ICD therapy and may be indicated in case of interrupted protection by an already implanted ICD, temporary inability to implant an ICD, or refusal of an indicated ICD.

Bridging a temporary high risk of sudden arrhythmic death. Experience with the wearable cardioverter defibrillator (WCD).

The implantable cardioverter defibrillator (ICD) is able to reduce sudden arrhythmic death in patients who are considered to be at high risk. However, the arrhythmic risk may be increased only temporarily as long as the proarrhythmic conditions persist, left ventricular ejection fraction remains low, or heart failure prevails. The wearable cardioverter defibrillator (WCD) represents an alternative approach to prevent sudden arrhythmic death until either ICD implantation is clearly indicated or the arrhythmic risk is considered significantly lower or even absent.

Evaluation of the effectiveness of a wearable cardioverter defibrillator detection algorithm.

Background: Wearable cardioverter defibrillators (WCDs) provide protection from sudden cardiac death. The efficacy of a WCD detection algorithm has not been reported outside of clinical trial.

Methods: The efficacy of the algorithm was reviewed through a retrospective analysis of appropriate shocks, inappropriate shocks, and arrhythmia detections during a 1-year period.

Exploring QT interval changes as a precursor to the onset of ventricular fibrillation/tachycardia.

In the present study, we have retrospectively analyzed the corrected QT (QTc) interval before spontaneous episodes of sudden cardiac arrest in patients with a wearable cardioverter defibrillator. Corrected QT interval was measured for all normal beats from 32 recordings of baseline rhythm and compared to normal rhythm before a paired spontaneous cardiac arrhythmia. Before arrhythmia, the QTc (505 +/- 73 ms) was not significantly longer than the baseline rhythm (497 +/- 73 ms) (P = .

Use of a wearable defibrillator in terminating tachyarrhythmias in patients at high risk for sudden death: results of the WEARIT/BIROAD.

The automatic ICD improves survival in patients with a history of sudden cardiac arrest. However, some patients do not meet the guidelines for ICD implantation or are unable to receive an implantable device. This study tested the hypothesis that these patients could benefit from a wearable cardioverter defibrillator.

Clinical efficacy of a wearable defibrillator in acutely terminating episodes of ventricular fibrillation using biphasic shocks.

The Wearable Cardioverter Defibrillator (WCD) automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander, while at the same time allowing the patient to ambulate freely. It represents an alternative to emergency medical services for outpatient populations with a temporary risk of sudden cardiac death. While the original devices used a monophasic truncated exponential waveform for cardioversion/defibrillation shocks, a new, biphasic shock was developed for the next device generation.