%0 Journal Article
%T Predictors of ventricular tachyarrhythmia in patients with a wearable cardioverter defibrillator: an international multicenter registry.
%A Kreimer F
%A Koepsel K
%A Gotzmann M
%A Kovacs B
%A Dreher TC
%A Blockhaus C
%A Klein N
%A Kuntz T
%A Shin DI
%A Lapp H
%A Rosenkaimer S
%A Abumayyaleh M
%A Hamdani N
%A Saguner AM
%A Erath JW
%A Duru F
%A Beiert T
%A Schiedat F
%A Weth C
%A Custodis F
%A Akin I
%A Mügge A
%A Aweimer A
%A El-Battrawy I
%J J Interv Card Electrophysiol
%V 0
%N 0
%D 2024 Jul 10
%M 38985244
%F 1.759
%R 10.1007/s10840-024-01869-w
%X OBJECTIVE: Wearable cardioverter defibrillator (WCD) can protect patients from sudden cardiac death due to ventricular tachyarrhythmias and serve as a bridge to decision of definite defibrillator implantation. The aim of this analysis from an international, multicenter WCD registry was to identify predictors of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) in this population.
METHODS: One thousand six hundred seventy-five patients with WCD were included in a multicenter registry from 9 European centers, with a median follow-up of 440 days (IQR 120-893). The primary study end point was the occurrence of sustained VT/VF.
RESULTS: Sustained VT was detected by WCD in 5.4% and VF in 0.9% of all patients. Of the 30.3% of patients receiving ICD implantation during follow-up, sustained VT was recorded in 9.3% and VF in 2.6%. Non-ischemic cardiomyopathy (HR 0.5, p < 0.001), and medication with angiotensin-converting enzyme inhibitors (HR 0.7, p = 0.027) and aldosterone antagonists (HR 0.7, p = 0.005) were associated with a significantly lower risk of VT/VF.
CONCLUSIONS: Patients who received WCD due to a transient increased risk of sudden cardiac death have a comparatively lower risk of VT/VF in the presence of non-ischemic cardiomyopathy. Of note, optimal medical treatment for heart failure not only results in an improvement in left ventricular ejection fraction but also in a reduction in the risk for VT/VF.