title: The Wearable Cardioverter Defibrillator in Nonischemic Cardiomyopathy: A US National Database Analysis.
abstract: The wearable cardioverter defibrillator (WCD) is often used in patients at risk of sudden cardiac death (SCD) who are not yet candidates for an implantable cardioverter defibrillator (ICD). Newly diagnosed cardiomyopathy may be reversible, and a WCD may protect patients during the initial period of risk. We evaluate the benefit and compliance of the WCD in patients with nonischemic cardiomyopathy (NICM).
  
  
  
  We reviewed a national database of patients with NICM who used WCDs and who self-reported a history of excess alcohol use, although other causes of cardiomyopathy could not be excluded. The database contained demographic data, initial ejection fraction (EF), reason for WCD prescription, compliance and use data, any detected arrhythmias, therapies, and reason for discontinuing WCD. Statistical analyses were performed using SAS, version 9.3 (SAS Institute, Cary, NC).
  
  
  
  Of the 127 patients, 88% were men with a mean age of 52.6 ± 11.0 years. The mean initial EF was 19.9% ± 7.4%. Patients wore the WCD for a median of 51 days and a median daily use of 18.0 hours per day. The most common reasons for discontinuing the WCD were improvement in EF (33%) or ICD implantation (23.6%). Seven patients (5.5%) had 9 sustained ventricular arrhythmia events, which were successfully treated with 100% conversion. There were 11 deaths (8.6%) during 100 days of follow-up. No deaths resulted from WCD shock failure or undersensing.
  
  
  
  NICM may have a significant risk of ventricular arrhythmias and death in the first few months. The WCD delivered appropriate therapy in 5.5% of patients. This study suggests that a WCD may be effective temporary prophylaxis for prevention of SCD in patients with newly diagnosed NICM.
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Negar
authors.initials: N
authors.lastname: Salehi
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Mojdeh
authors.initials: M
authors.lastname: Nasiri
authors.affiliation: ZOLL Medical Corporation, Pittsburgh, Pennsylvania, USA.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Bianco
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Madalina
authors.initials: M
authors.lastname: Opreanu
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Vini
authors.initials: V
authors.lastname: Singh
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Satija
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Aravdeep S
authors.initials: AS
authors.lastname: Jhand
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Lilit
authors.initials: L
authors.lastname: Karapetyan
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Abdul Rahman
authors.initials: AR
authors.lastname: Safadi
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA.
authors.forename: Phani
authors.initials: P
authors.lastname: Surapaneni
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Departments of Epidemiology and Biostatistics, and Internal Medicine, Michigan State University, Lansing, Michigan, USA. Electronic address: thakur@msu.edu.
authors.forename: Ranjan K
authors.initials: RK
authors.lastname: Thakur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002310:Cardiomyopathy, Alcoholic / Q000628:therapy*; D016208:Databases, Factual; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017180:Tachycardia, Ventricular / Q000150:complications / Q000628:therapy; D014693:Ventricular Fibrillation / Q000150:complications / Q000628:therapy