Related Experiment Video
Updated: Feb 20, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Real world utilization and impact of the wearable cardioverter-defibrillator in a community setting
Aditi Naniwadekar1, Talal Alnabelsi2, Kamal Joshi1
1The Institute for Heart and Vascular Health, Einstein Medical Center, Philadelphia, PA, United States.
Insights
The wearable cardioverter-defibrillator (WCD) effectively prevents sudden cardiac death (SCD) in high-risk patients, demonstrating high compliance and appropriate shock delivery. This approach may reduce the need for permanent intracardiac defibrillator (ICD) implantation.
Area of Science:
- Cardiology
- Medical Devices
- Public Health
Background:
- Wearable cardioverter-defibrillators (WCDs) serve as a crucial bridge for patients at risk of sudden cardiac death (SCD) who are not immediate candidates for intracardiac defibrillator (ICD) implantation.
- This study focuses on the application and outcomes of WCD use in a community setting.
Purpose of the Study:
- To evaluate the effectiveness and compliance of WCD use in a diverse patient population.
- To assess the rate of appropriate and inappropriate shocks delivered by WCDs.
- To determine the long-term outcomes, including the need for ICD implantation, after WCD use.
Main Methods:
- A retrospective study was conducted on 140 patients discharged with a WCD from January 2002 to October 2015.
- Clinical data were extracted from hospital records, and WCD usage data were obtained from the Zoll LifeVest database.
- Patient demographics, cardiac conditions, WCD usage patterns, and shock events were analyzed.
Main Results:
- The study population (n=140) was predominantly African-American (85.9%) with a mean age of 58.2 years, primarily suffering from non-ischemic cardiomyopathy (46%).
- WCDs were used for a median of 43 days, with high daily compliance (17.3 hours).
- A total of 6 shocks occurred, with 2 (1.4%) being appropriate (for VT/VF) and 4 (2.8%) inappropriate. Importantly, 32% of patients ultimately did not require ICD implantation, and 32% showed improved ejection fraction.
Conclusions:
- WCDs demonstrate high compliance and effectiveness in preventing SCD in a predominantly minority community setting.
- While inappropriate shocks can occur, WCDs provide a valuable therapeutic option.
- A significant proportion of patients may not require subsequent ICD implantation, suggesting WCDs could be a cost-effective strategy for managing SCD risk.
Introduction:
The wearable cardioverter-defibrillator (WCD) is used in patients at risk for sudden cardiac death (SCD) but not immediate candidates for intracardiac defibrillator (ICD) implantation.
Methods:
We performed a single center retrospective study of patients prescribed WCD upon hospital discharge from January 2002 to October 2015. Clinical characteristics were obtained from the hospital electronic database and device data from Zoll LifeVest database.
Results:
Of 140 patients, 62% were men, 85.9% were African-American and mean age was 58.2 ± 15.5 years. Ischemic cardiomyopathy was present in 45 (32%) and non-ischemic cardiomyopathy in 64 patients (46%). Mean left ventricular ejection fraction (EF) was 0.28 ± 0.4. WCD was worn for 7657 patient-days (21 patient-years), with each patient using WCD for median of 43 days (IQR: 7-83 days), and daily mean use 17.3 ± 7.5 h. There were a total of 6 (4.2%) WCD shocks of which 2 (1.4%) were appropriate (one for VT, one for VF) and 4 (2.8%) were inappropriate (2 had supraventricular tachycardia, 2 had artifact). Two patients who received appropriate shocks were African-American with non-ischemic cardiomyopathy (EF<20%), non-sustained VT and wide QRS duration. Upon termination of WCD use, 45 (32%) received ICD while EF improved in 34 patients (32%).
Conclusions:
In a predominantly minority, community setting, WCD compliance is high and use is effective in aborting SCD. However, inappropriate shocks do occur. A significant proportion of patients did not ultimately require ICD implantation suggesting this may be a cost-effective strategy in patients at risk of SCD.
More Related Videos
15:00Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies
Published on: February 3, 2023
16:40A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Related Concept Videos
01:23Cardiopulmonary Resuscitation III: AED Use
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:29Cardiomyopathy V: Interprofessional Care
01:21Cardiopulmonary Resuscitation I: Adult
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:23Holter Monitor: 24-Hour Monitoring