Clinical Outcomes: Post-MI WCD Study

Retrospective study examined the utility of providing the WCD to more than 8,400 patients determined to be at high risk of SCD during the post-MI waiting period.

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Cardiologist sitting and talking with a LifeVest wearable cardioverter defibrillator patient

Wearable Cardioverter-Defibrillator Use in Patients Perceived to Be at High Risk Early Post-Myocardial Infarction

Purpose

This study was conducted to better understand the incidence, survival, and timing of VT/VF in post-myocardial infarction (MI) patients with a low ejection fraction (EF) that wore a Wearable Cardioverter-Defibrillator (WCD) during mandated waiting periods following MI.

Methods

Retrospective study of U.S. patients (n=8,453), age 62.7 ± 12.7, that were recorded in a nationwide registry of post-market release WCDs from September 27, 2005 through July 13, 2011.
Patients studied had a recent MI and an EF of ≤ 35%.

Graph showing timing of WCD shock events per month of WCD use

Key results

1.6% (n=133) of patients were appropriately treated by the WCD with a median time to treatment of 16 days.
- Median time to treatment in post-revascularization patients was 14 days.
75% (n=100) of treated patients received therapy during the first 30 days post-MI and 96% (n=128) of patients received therapy within the first 3 months of WCD use.
Overall post-event survival in patients treated with the WCD was 91% (95% in revascularized patients and 84% in non-revascularized patients).

Conclusions

Most of the WCD treatments observed during the course of the study occurred within the highest risk period, the first 90 days following a cardiac event.
The WCD is an effective therapeutic option for treating VT/VF in the early period post-MI and post-revascularization in patients with left ventricular dysfunction.

Source: Epstein AE, Abraham WT, Bianco NR, et al. Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post myocardial infarction. J Am Coll Cardiol. 2013;62(21):2000–2007.

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