title: Use of the wearable cardioverter defibrillator in high-risk cardiac patients: data from the Prospective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry).
abstract: BACKGROUND
  Prospective data on the safety and efficacy of the wearable cardioverter defibrillator (WCD) in a real-world setting are lacking. The Prospective Registry of Patients Using the Wearable Defibrillator (WEARIT-II) Registry was designed to provide real-world data on the WCD as a strategy during a period of risk stratification.
  
  
  RESULTS
  The WEARIT-II Registry enrolled 2000 patients with ischemic (n=805, 40%), or nonischemic cardiomyopathy (n=927, 46%), or congenital/inherited heart disease (n=268) prescribed WCD between August 2011 and February 2014. Clinical data, arrhythmia events, implantable cardioverter defibrillator implantation, and improvement in ejection fraction were captured. The median age was 62 years; the median ejection fraction was 25%. The median WCD wear time was 90 days, with median daily use of 22.5 hours. There was a total of 120 sustained ventricular tachyarrhythmias in 41 patients, of whom 54% received appropriate WCD shock. Only 10 patients (0.5%) received inappropriate WCD therapy. The rate of sustained ventricular tachyarrhythmias by 3 months was 3% among patients with ischemic cardiomyopathy and congenital/inherited heart disease, and 1% among nonischemic patients (P=0.02). At the end of WCD use, 840 patients (42%) were implanted with an implantable cardioverter defibrillator. The most frequent reason not to implant an implantable cardioverter defibrillator following WCD use was improvement in ejection fraction.
  
  
  CONCLUSIONS
  The WEARIT-II Registry demonstrates a high rate of sustained ventricular tachyarrhythmias at 3 months in at-risk patients who are not eligible for an implantable cardioverter defibrillator, and suggests that the WCD can be safely used to protect patients during this period of risk assessment.
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY. Valentina.Kutyifa@heart.rochester.edu.
authors: Valentina
authors: V
authors: Kutyifa
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Arthur J
authors: AJ
authors: Moss
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Helmut
authors: H
authors: Klein
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Yitschak
authors: Y
authors: Biton
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Scott
authors: S
authors: McNitt
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Bonnie
authors: B
authors: MacKecknie
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Wojciech
authors: W
authors: Zareba
authors: From University of Rochester Medical Center, Cardiology Division, Heart Research Follow-up Program, Rochester, NY.
authors: Ilan
authors: I
authors: Goldenberg
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D009202:Cardiomyopathies / Q000150:complications; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D047548:Defibrillators / Q000009:adverse effects / Q000706:statistics & numerical data; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data; D004554:Electric Countershock / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D010349:Patient Compliance; D055656:Prescriptions / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries; D013318:Stroke Volume
chemical_list: D002317:Cardiovascular Agents
keywords: death, sudden, cardiac; defibrillator, implantable; defibrillators; tachycardia, ventricular