■尽管已知临床益处，对于显著比例的射血分数降低的HF患者,指南推荐的心率(HR)控制未实现.可穿戴心律转复除颤器（WCD）提供连续的HR监测和警报，可以帮助药物滴定。
■本研究旨在评估在使用WCD期间实现指南推荐的HR控制的性别差异。
■从2015年至2018年安装WCD的患者的数据来自制造商的数据库（ZOLL）。按性别比较了在使用开始（BOU）和使用结束（EOU）时具有足够夜间静息HR控制的患者比例。适当的HR控制被定义为具有夜间中值HR<70次搏动/分钟。
■最终数据集中包含了21,440名女性和17,328名男性的比较样本（WCD佩戴的中位数为90[IQR59-116]天）。在没有接受电击的患者中，超过一半的人在BOU人力资源控制不足(59%的女性，53%的男性）。尽管静息心率≥70次/分钟的患者比例通过EOU改善，43%的女性和36%的男性没有达到指南推荐的HR控制。
■相当比例的女性和男性在药物治疗优化期间没有达到足够的HR控制。和男人相比,接受WCD电击的女性在室性快速性心律失常/室颤前一周内HR控制不足的比例较高，未休克的女性为43％，与36%的男性相比，在研究期间未达到足够的HR控制。WCD可用作远程监测工具，以记录HR并告知β-受体阻滞剂的充分上调，特别注重缩小女性的治疗差距。
UNASSIGNED: Despite known clinical benefits,
guideline-recommended heart rate (HR) control is not achieved for a significant proportion of patients with HF with reduced ejection fraction. The wearable cardioverter-defibrillator (WCD) provides continuous HR monitoring and alerts that could aid medication titration.
UNASSIGNED: This study sought to evaluate sex differences in achieving
guideline-recommended HR control during a period of WCD use.
UNASSIGNED: Data from patients fitted with a WCD from 2015 to 2018 were obtained from the manufacturer\'s database (ZOLL). The proportion of patients with adequate nighttime resting HR control at the beginning of use (BOU) and at the end of use (EOU) were compared by sex. Adequate HR control was defined as having a nighttime median HR <70 beats/min.
UNASSIGNED: A total of 21,440 women and a comparative sample of 17,328 men (median 90 [IQR 59-116] days of WCD wear) were included in the final dataset. Among patients who did not receive a shock, over half had insufficient HR control at BOU (59% of women, 53% of men). Although the proportion of patients with resting HR ≥70 beats/min improved by EOU, 43% of women and 36% of men did not achieve
guideline-recommended HR control.
UNASSIGNED: A significant proportion of women and men did not achieve adequate HR control during a period of medical therapy optimization. Compared with men, a greater proportion of women receiving WCD shocks had insufficiently controlled HR in the week preceding ventricular tachyarrhythmia/ventricular fibrillation and 43% of nonshocked women, compared with 36% of men, did not reach adequate HR control during the study period. The WCD can be utilized as a remote monitoring tool to record HR and inform adequate uptitration of beta-blockers, with particular focus on reducing the treatment gap in women.
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