One‐year follow‐up of the prospective registry of patients using the wearable defibrillator (WEARIT‐II Registry)

Background The WEARIT‐II Registry demonstrated efficacy and safety of the wearable cardioverter defibrillator (WCD) for at‐risk cardiac patients. However, 1‐year outcomes in this population have not been reported. Methods The WEARIT‐II Registry enrolled 2,000 U.S. patients prescribed the WCD. One‐ye...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2018-10, Vol.41 (10), p.1307-1313
Main Authors: Kutyifa, Valentina, Moss, Arthur J., Klein, Helmut U., McNitt, Scott, Zareba, Wojciech, Goldenberg, Ilan
Format: Article
Language:English
Subjects:
Arrhythmia
Cardiomyopathy
Cardiovascular disease
Congenital diseases
Coronary artery disease
Data processing
Defibrillators
Etiology
Heart diseases
implantable cardioverter defibrillator
Ischemia
Mortality
outcomes
sudden cardiac death
Survival
Survival analysis
Syncope
Ventricle
ventricular tachyarrhythmias
wearable cardioverter defibrillator
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Summary:Background The WEARIT‐II Registry demonstrated efficacy and safety of the wearable cardioverter defibrillator (WCD) for at‐risk cardiac patients. However, 1‐year outcomes in this population have not been reported. Methods The WEARIT‐II Registry enrolled 2,000 U.S. patients prescribed the WCD. One‐year mortality data from start of WCD use were prospectively collected for 1,846 patients (93%). Outcome data were analyzed by disease etiology and implantable cardioverter defibrillator (ICD) implantation following WCD use. Results During 12 months of follow‐up, 73 patients died (4%). Kaplan‐Meier survival analysis showed differences in all‐cause mortality from WCD prescription between patients with ischemic versus nonischemic cardiomyopathy versus congenital/inherited heart disease (4% vs 3% vs 7%, P = 0.013). Patients with ventricular arrhythmia events during WCD use had a higher 1‐year mortality (10% vs 3%, P = 0.042). Renal disease, increasing age, prior syncope, and nonbeta‐blocker use predicted mortality. One‐year mortality was similar in patients who did versus did not receive an ICD following WCD use in ischemic (3% vs 4%, P = 0.470) and nonischemic cardiomyopathy (3% vs 3%, P = 0.892). Patients with congenital/inherited heart disease with no implanted ICD had a trend toward a higher rate of mortality than those who received an ICD (8% vs 3%, P = 0.082). Multivariate models confirmed these findings. Conclusion One‐year follow‐up from the WEARIT‐II Registry shows an overall good survival in patients prescribed the WCD. Short‐term use of WCD allows appropriate risk stratification for decision on an ICD implantation in at‐risk ischemic and nonischemic cardiomyopathy patients. Congenital/inherited heart disease patients had a higher risk of 1‐year mortality even without an implanted ICD post‐WCD.
ISSN:0147-8389
1540-8159
DOI:10.1111/pace.13448