• Humans
• Defibrillators
• Wearable Electronic Devices
• Out-of-Hospital Cardiac Arrest/therapy
• Cardiopulmonary Resuscitation/methods
• Cardiopulmonary Resuscitation/instrumentation
• Electric Countershock/methods
• Electric Countershock/instrumentation

• cardiac dysfunction
• heart failure
• implantable cardioverter–defibrillator
• ischemic cardiomyopathy
• revascularization

• asystole
• defibrillator
• sudden cardiac death
• ventricular arrhythmias

• United States
• Humans
• Electric Countershock/adverse effects
• Heart Arrest/therapy
• Ventricular Fibrillation
• Tachycardia, Ventricular
• Atrial Fibrillation
• Defibrillators
• Hospitals

• Arrhythmogenesis
• Defibrillation
• Inappropriate shock
• Resuscitation
• Suddencardiac death
• Ventricular arrhythmia
• Wearable defibrillator

• Humans
• Electric Countershock/adverse effects
• Defibrillators, Implantable/adverse effects
• Ventricular Fibrillation
• Tachycardia, Ventricular/therapy
• Tachycardia, Ventricular/complications
• Death, Sudden, Cardiac/etiology
• Death, Sudden, Cardiac/prevention & control
• Atrial Fibrillation/complications
• Tachycardia, Supraventricular/complications
• Tachycardia, Paroxysmal

• Cardiovascular disease
• Patient management system
• Sudden cardiac death
• Wearable cardioverter defibrillator

• SC130007 The U.S. Department of Defense, Spinal Cord Injury Research Program (SCIRP)
• AWD-00482 The Michael Smith Foundation for Health Research (MSFHR)

• Humans
• Middle Aged
• Aged
• Coronary Artery Disease/epidemiology
• Coronary Artery Disease/surgery
• Percutaneous Coronary Intervention/methods
• Incidence
• Prospective Studies
• East Asian People
• Risk Factors
• Death, Sudden, Cardiac/epidemiology
• Registries
• Treatment Outcome

• life vest
• quality-of-life
• sudden cardiac death
• ventricular fibrillation
• ventricular tachycardia
• wearable cardioverter-defibrillator

• funding

• Behavioral development
• Cortisol
• Neonatal behavior
• Prenatal depression

• Implantable cardioverter-defibrillator
• Myocardial infarction
• Sudden cardiac death
• Ventricular tachycardia
• Wearable cardioverter-defibrillator

• Humans
• Death, Sudden, Cardiac/etiology
• Death, Sudden, Cardiac/prevention & control
• Electric Countershock/adverse effects
• Defibrillators, Implantable/adverse effects
• Cardiomyopathies/complications
• Myocardial Infarction/complications
• Wearable Electronic Devices/adverse effects
• Defibrillators
• Randomized Controlled Trials as Topic

• Medizinische Fakultät Heidelberg der Universität Heidelberg (9149)

• Acute myocardial infarction
• Left ventricular ejection fraction
• Primary percutaneous coronary intervention (PCI)
• Sudden cardiac death

• Death, Sudden, Cardiac/epidemiology
• Death, Sudden, Cardiac/etiology
• Death, Sudden, Cardiac/prevention & control
• Hospitals
• Humans
• Myocardial Infarction
• Patient Discharge
• Percutaneous Coronary Intervention
• Risk Factors
• Stroke Volume
• Treatment Outcome
• Ventricular Function, Left

• Wearable cardioverter-defibrillator
• female
• male
• sex differences
• sudden cardiac death

• Cost-effectiveness
• Health technology assessment
• Myocardial infarction
• Quality of life
• Sudden cardiac death
• Wearable cardioverter defibrillator

• Guidelines
• acute heart failure
• advanced heart failure
• arrhythmias
• cardiac resynchronization therapy
• comorbidities
• diagnosis
• ejection fraction
• heart failure
• hospitalization
• mechanical circulatory support
• multidisciplinary management
• natriuretic peptides
• neuro-hormonal antagonists
• pharmacotherapy
• transplantation

• defibrillator
• heart failure
• monitoring
• sudden cardiac death
• telemedicine
• ventricular arrhythmia

• Arrhythmias, Cardiac
• Death, Sudden, Cardiac
• Defibrillators, Implantable
• Electric Countershock
• Humans
• Wearable Electronic Devices

• Sudden cardiac death
• defibrillation
• myocardial infarction
• ventricular tachyarrhythmia
• wearable cardioverter-defibrillators

• heart failure
• heart failure monitoring
• sudden cardiac death
• wearable cardioverter–defibrillator

• Death, Sudden, Cardiac
• Defibrillators, Implantable
• Feasibility Studies
• Female
• Heart Failure/diagnosis
• Heart Failure/therapy
• Humans
• Male
• Stroke Volume
• Ventricular Function, Left
• Wearable Electronic Devices

• advanced heart failure
• transplantation
• Guidelines
• acute heart failure
• arrhythmias
• cardiac resynchronization therapy
• comorbidities
• diagnosis
• ejection fraction
• heart failure
• hospitalization
• mechanical circulatory support
• multidisciplinary management
• natriuretic peptides
• neuro-hormonal antagonists
• pharmacotherapy

• Cardiac Resynchronization Therapy
• Chronic Disease
• Heart Failure/diagnosis
• Heart Failure/therapy
• Humans
• Stroke Volume

Sudden cardiac death is one of the leading causes of death in the older population. Compared with the general population, patients who experienced a myocardial infarction are four to six times more likely to experience sudden cardiac death. Though primary percutaneous coronary intervention considerably reduces mortality in patients who experienced a myocardial infarction, a non-negligible number of sudden cardiac deaths still occurs. Despite the high incidence rate of sudden cardiac deaths during the first month after myocardial infarction, prophylactic use of implantable cardioverter-defibrillators has so far failed to convey a survival benefit. Therefore, current clinical guidelines recommend that cardioverter-defibrillator implantation is contraindicated until 90 days after myocardial infarction. Wearable cardioverter-defibrillators were first approved for clinical use in 2002 and are currently considered as a bridge to therapy in patients with myocardial infarction with a reduced left ventricular ejection fraction in whom cardioverter-defibrillator implantation is temporarily not indicated. However, there is insufficient recognition among interventional cardiologists of the use of wearable cardioverter-defibrillators for preventing sudden cardiac death after myocardial infarction. Hence, we reviewed the evidence of the efficacy of wearable cardioverter-defibrillators used in patients following myocardial infarction to achieve better management of sudden cardiac death.

• Left ventricular dysfunction
• Myocardial infarction
• Prognosis
• Sudden cardiac death
• Wearable cardioverter-defibrillator

Myocarditis may lead to malignant arrhythmias and sudden cardiac death. As of today, there are no reliable predictors to identify individuals at risk for these catastrophic events. The aim of this study was to evaluate if a wearable cardioverter defibrillator (WCD) may detect and treat such arrhythmias adequately in the peracute setting of myocarditis.

In this observational, retrospective, single centre study, we reviewed patients presenting to the Charité Hospital from 2009 to 2017, who were provided with a WCD for the diagnosis of myocarditis with reduced ejection fraction (<50%) and/or arrhythmias. Amongst 259 patients receiving a WCD, 59 patients (23%) were diagnosed with myocarditis by histology. The mean age was 46 ± 14 years, and 11 patients were women (19%). The mean WCD wearing time was 86 ± 63 days, and the mean daily use was 20 ± 5 h. During that time, two patients (3%) had episodes of sustained ventricular tachycardia (VT; four total) corresponding to a rate of 28 sustained VT episodes per 100 patient‐years. Consequently, one of these patients underwent rhythm stabilization through intravenous amiodarone, while the other patient received an implantable cardioverter defibrillator. Two patients (3.4%) were found to have non‐sustained VT.

Using a WCD after acute myocarditis led to the detection of sustained VT in 2/59 patients (3%). While a WCD may prevent sudden cardiac death after myocarditis, our data suggest that WCD may have impact on clinical management through monitoring and arrhythmia detection.

• HFmrEF
• HFrEF
• Myocarditis
• Wearable cardioverter defibrillator

• Sudden death
• WCD
• arrhythmia
• cardiology
• wearable cardioverter defibrillator

• External defibrillator
• Sudden cardiac arrest
• Ventricular fibrillation
• Ventricular tachycardia
• Wearable cardioverter defibrillator

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. The aim of this study was therefore to investigate the clinical and health economic impacts of WCD use among Medicare patients hospitalized for MI. A 5% sample of Medicare’s Standard Analytical Files (2010–2012) was used to identify patients. Beneficiaries with an acute inpatient admission for acute MI were stratified by WCD presence and absence, respectively. Baseline clinical history, all-cause mortality, and the total cost of health-care expenditures over one year were collected. In total, 16,935 patients were included in the final analysis; of these, 89 were placed in the WCD group and 16,846 were placed in the non-WCD group. Overall, WCD patients were younger (70 versus 74 years of age; p < 0.001), more likely to be male (74.2% versus 57.4%; p = 0.002), and more likely to have congestive heart failure and/or ventricular arrhythmias prior to the indexed acute MI. At 30 days, the mortality rate in the WCD group (not reported due to volume < 11 Medicare beneficiaries) was lower in comparison with the non-WCD group (10.4%; p = 0.18). At one year, the adjusted mortality rates were 11.5% for the WCD group and 19.8% for the non-WCD group (hazard ratio: 0.46; p = 0.017). For the WCD group, the one-year incremental cost-effectiveness ratio was $12,373 per life-year gained. Among Medicare beneficiaries, WCD use after an acute MI was associated with better 30-day and one-year survival. Thus, our findings indicate that WCD use was cost-effective in the present sample of Medicare patients.

• Cost–benefit analysis
• Medicare
• mortality
• myocardial infarction
• wearable cardioverter-defibrillator

The prospective WEARIT-II-EUROPE registry aimed to assess the value of the wearable cardioverter-defibrillator (WCD) prior to potential ICD implantation in patients with heart failure and reduced ejection fraction considered at risk of sudden arrhythmic death.

781 patients (77% men; mean age 59.3 ± 13.4 years) with heart failure and reduced left ventricular ejection fraction (LVEF) were consecutively enrolled. All patients received a WCD. Follow-up time for all patients was 12 months. Mean baseline LVEF was 26.9%. Mean WCD wearing time was 75 ± 47.7 days, mean daily WCD use 20.3 ± 4.6 h. WCD shocks terminated 13 VT/VF events in ten patients (1.3%). Two patients died during WCD prescription of non-arrhythmic cause. Mean LVEF increased from 26.9 to 36.3% at the end of WCD prescription (p < 0.01). After WCD use, ICDs were implanted in only 289 patients (37%). Forty patients (5.1%) died during follow-up. Five patients (1.7%) died with ICDs implanted, 33 patients (7%) had no ICD (no information on ICD in two patients). The majority of patients (75%) with the follow-up of 12 months after WCD prescription died from heart failure (15 patients) and non-cardiac death (15 patients). Only three patients (7%) died suddenly. In seven patients, the cause of death remained unknown.

Mortality after WCD prescription was mainly driven by heart failure and non-cardiovascular death. In patients with HFrEF and a potential risk of sudden arrhythmic death, WCD protected observation of LVEF progression and appraisal of competing risks of potential non-arrhythmic death may enable improved selection for beneficial ICD implantation.

• Heart failure
• Implantable cardioverter-defibrillator
• Sudden cardiac death
• Wearable cardioverter-defibrillator

• Death, Sudden, Cardiac/epidemiology
• Death, Sudden, Cardiac/prevention & control
• Defibrillators
• Electric Countershock/instrumentation
• Electric Countershock/methods
• Health Services Misuse
• Humans
• Patient Selection
• United States
• Wearable Electronic Devices

• Sudden cardiac death
• Wearable cardioverter-defibrillator