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Aggregate National Experience With the Wearable Cardioverter-Defibrillator
Open accessAbstract
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. Survival, using the Social Security Death Index, was compared with survival in implantable cardioverter-defibrillator (ICD) patients.Results Of 3,569 patients wearing the WCD (age 59.3+/-14.7 years, duration 52.6+/-69.9 days), daily use was 19.9+/-4.7 h (>90% of the day) in 52% of patients. More days of use correlated with higher daily use (p<0.001). Eighty sustained VT/VF events occurred in 59 patients (1.7%). First-shock success was 76 of 76 (100%) for unconscious VT/VF and 79 of 80 (99%) for all VT/VF. Eight patients died after successful conversion of unconscious VT/VF (89.5% survival of VT/VF events). Asystole occurred in 23 (17 died), pulseless electrical activity in 2, and respiratory arrest in 1 (3 died), representing 24.5% of sudden cardiac arrests. During WCD use, 3,541 of 3,569 patients (99.2%) survived overall. Survival occurred in 72 of 80 (90%) VT/VF events and 78 of 106 (73.6%) for all events. Long-term mortality was not significantly different from first ICD implant patients but highest among patients with traditional ICD indications.Conclusions Compliance was satisfactory with 90% wear time in >50% of patients and low sudden death mortality during use. Survival was comparable to that of ICD patients. However, asystole was an important cause of mortality in sudden cardiac arrest events.
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“LiveVest showed comparable outcomes to implantable cardiac devices in a 3-year study (n = 3569) with acute event survival at 99.2% [38].”
From Wearables and the Medical Revolution (2018) · cites this paper as [38]
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The wearable cardioverter-defibrillator is not needed for most high-risk patients
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Metadata
- Authors
- Chung, M. K., Szymkiewicz, S. J., Shao, M., Zishiri, E., Niebauer, M. J., Lindsay, B. D., & Tchou, P. J.
- Affiliations
- Cleveland Clinic (US)
- ZOLL Medical Corporation (United States) (US)
- Corresponding author
- Chung, Mina K.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 56
- Issue
- 3
- Pages
- 194-203
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC2962668
- OpenAlex
- W2159588890
- Cited by
- 297
- References
- 16
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 15 · 2022: 11 · 2021: 19 · 2020: 26 · 2019: 21 · 2018: 28 · 2017: 33 · 2016: 39 · 2015: 20 · 2014: 14 · 2013: 19 · 2012: 13
- FWCI
- 10.98
- Type
- journal article
- Language
- en
- Update notices
- erratum (2011-01-11)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Medtronic, Inc.
- Boston Scientific
- St. Jude Medical
- Biotronik
- Medtronic
- National Institutes of Health (NIH R01 HL090620)
- ZOLL
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- wearable cardioverter defibrillator, medication adherence, sudden cardiac death prevention, ventricular tachycardia, ventricular fibrillation, implantable cardioverter-defibrillator, survival, asystole, sudden cardiac arrest, post-market registry
- MeSH terms
- Female, Humans, Male, Middle Aged, Patient Compliance, Ventricular Fibrillation, Death, Sudden, Cardiac, Tachycardia, Ventricular, Defibrillators
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