Sex differences and adherence of patients treated with wearable cardioverter‐defibrillator: Insights from an international multicenter register

Abstract

Aims: Treatment with the wearable cardioverter defibrillator (WCD) may protect against sudden cardiac death (SCD) as a bridging therapy until a cardioverterdefibrillator may be implanted. We analyzed in a multicenter setting a consecutive patient cohort wearing WCD to explore sex differences. Methods and Results:We analyzed 708 consecutive patients, 579 (81.8%) from whom were males and 129 (18.2%) females (age, 60.5 ± 14 vs. 61.6 ± 17 years old; p = .44). While the rate of ischemic cardiomyopathy (ICM) as a cause of prescription of WCD was significantly higher in males as compared to females (42.7% vs. 26.4%; p = .001), females received it more frequently due to nonischemic cardiomyopathy (NICM) (55.8% vs. 42.7%); p = .009). The wear time of WCD was equivalent in both groups (21.1 ± 4.3 h/days in males vs. 21.5 ± 4.4 h/days in females; p = .27; and 62.6 ± 44.3 days in males vs. 56.5 ± 39 days in females; p = .15). Mortality was comparable in both groups at 2-year-follow-up (6.8% in males vs. 9.7% in females; p = .55). Appropriate WCD shocks and the incidence of ICD implantations were similar in both groups (2.4% in males vs. 3.9% in females; p = .07) (35.1% in males vs. 31.8% in females; p = .37), respectively. In age tertile analysis, compliance was observed more in 73-91 years old group as compared with 14-51 years old group (87.8% vs. 68.3%; p < .001). Conclusion:Compliance for wearing WCD was excellent regardless of sex. Furthermore, mortality and the incidence of ICD implantations were comparable in both sexes. Appropriate WCD shocks were similar in both sexes.

Age differences of patients treated with wearable cardioverter defibrillator: Data from a multicentre registry

“…Previously published data to define factors, which are associated with the likelihood of medication non‐adherence among Medicare low‐income subsidy recipients with type 2 diabetes, hypertension or heart failure showed that both young age and male gender are associated with low compliance 11 . Recently published descriptive data showed that the compliance rate regarding wearing a WCD is comparable in males and females 12,13 …”

“…11 Recently published descriptive data showed that the compliance rate regarding wearing a WCD is comparable in males and females. 12,13 A further important aspect is that NICM is also associated with low compliance. Of note, recently published data suggest that a prolonged period of OMT and a prolonged WCD use in newly diagnosed NICM and ICM is increasing the rate of patients who may not need ICD implantation.…”

Characteristics and outcome of wearable cardioverter‐defibrillator therapy stratified by gender: Insights from a multicenter international registry

“…The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request. Thomas Kuntz MD 4 Norbert Klein MD 4 Boldizsar Kovacs MD, MSc 5 Firat Duru MD 5 Ardan M. Saguner MD 5 Christian Blockhaus MD 6,7 Dong-In Shin MD 6,7 Michael Gotzmann MD 8 Hendrik Lapp MD 9 Thomas Beiert MD 9 Andreas Mügge MD, PhD 2,10 Ibrahim El-Battrawy MD 2,10 Ibrahim Akin MD, PhD…”

“…3 In our recently published data, we investigated clinical outcome and adherence in a smaller cohort. 4 To analyze gender differences, we investigated in a multicenter−multinational setting (nine centers) a large patient cohort treated with WCD (n = 1596) Table 1.Data from a total of 1596 patients (332 females, 20.8% and 1264 males, 79.2%) regarding indication for wearing WCD, WCD shocks, adherence, and clinical outcome after termination of WCD use at mean follow-up of 20.6 ± 20.3 months were analyzed. Both…”

“…3 In our recently published data, we investigated clinical outcome and adherence in a smaller cohort. 4 To analyze gender differences, we investigated in a multicenter−multinational setting (nine centers) a large patient cohort treated with WCD (n = 1596) Table 1.…”