What is the clinical evidence from this study?

Study design: Cohort. Population: Risk of sudden cardiac death (n=3569). Intervention: Wearable cardioverter-defibrillator (WCD) vs. Implantable cardioverter-defibrillator (ICD) patients. Primary outcome: Overall survival and long-term mortality.

What question did this study set out to answer?

This study aims to evaluate patient compliance and the effectiveness of the wearable cardioverter-defibrillator (WCD) in preventing sudden death.

June 26, 2026Open Access

Aggregate National Experience With the Wearable Cardioverter-Defibrillator

Key Result

The wearable cardioverter-defibrillator was associated with 99.2% overall survival during use, with long-term mortality comparable to that of patients receiving a first ICD implant.

Key Points

This study aims to evaluate patient compliance and the effectiveness of the wearable cardioverter-defibrillator (WCD) in preventing sudden death.
Data collected from a nationwide registry of post-market WCDs.
Survival rates compared using the Social Security Death Index against implantable cardioverter-defibrillator (ICD) patients.
Compliance and event data recorded, with analysis of VT/VF management.
Of 3,569 patients, 52% had >90% compliance (>19.9 hours daily use).
WCD demonstrated 100% first-shock success for unconscious VT/VF events, and 90% survival during VT/VF incidents.
Mortality rates during WCD use were low; survival was comparable to ICD patients but asystole was a significant cause of death.

Study Design

Type

Cohort (n=3,569)

Multicenter

Yes

Structured PICO

Does the wearable cardioverter-defibrillator (WCD) provide effective antiarrhythmic treatment and comparable survival to ICDs in at-risk patients?

Population

3,569 patients (mean age 59.3 years) wearing a wearable cardioverter-defibrillator, followed for a mean duration of 52.6 days.

Exposure

Wearable cardioverter-defibrillator (WCD) worn for a mean duration of 52.6 days

Comparator

Implantable cardioverter-defibrillator (ICD) patients (for long-term survival comparison)

Outcome

Patient compliance (daily use) and effectiveness of antiarrhythmic treatment (first-shock success, survival of VT/VF events, overall survival)hard clinical

The wearable cardioverter-defibrillator demonstrates high compliance and high first-shock success for VT/VF, yielding survival rates comparable to traditional ICDs.

Abstract

OBJECTIVES: The purpose of this study was to determine patient compliance and effectiveness of antiarrhythmic treatment by the wearable cardioverter-defibrillator (WCD). BACKGROUND: Effectiveness of the WCD for prevention of sudden death is dependent on event type, patient compliance, and appropriate management of ventricular tachycardia/ventricular fibrillation (VT/VF). METHODS: Compliance and events were recorded in a nationwide registry of post-market release WCDs. Survival, using the Social Security Death Index, was compared with survival in implantable cardioverter-defibrillator (ICD) patients. RESULTS: Of 3,569 patients wearing the WCD (age 59.3+/-14.7 years, duration 52.6+/-69.9 days), daily use was 19.9+/-4.7 h (>90% of the day) in 52% of patients. More days of use correlated with higher daily use (p50% of patients and low sudden death mortality during use. Survival was comparable to that of ICD patients. However, asystole was an important cause of mortality in sudden cardiac arrest events.

Expert Takes1 quote

“Until recently, data regarding the incidence of sudden death and the utility of a wearable defibrillator for patients in these specific scenarios were scant. Also, patient compliance with this device on a large-scale level was a concern.”

Ralph J. Verdino, Cardiologist, institutional affiliation not specified<UNKNOWN>auto_pipelineView source

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