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One‐year follow‐up of the prospective registry of patients using the wearable defibrillator (WEARIT‐II Registry)
Author(s) -
Kutyifa Valentina,
Moss Arthur J.,
Klein Helmut U.,
McNitt Scott,
Zareba Wojciech,
Goldenberg Ilan
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13448
Subject(s) - medicine , cardiology , cardiomyopathy , population , mortality rate , heart disease , heart failure , environmental health
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.