Findings from an international trial, published in the New England Journal of Medicine, suggest wearable cardioverter defibrillators do not lead to a significantly lower rate of arrhythmic death among patients with a recent myocardial infarction and an ejection fraction of 35 per cent or less.
The Vest Prevention of Early Sudden Death Trial (VEST) included 2,302 patients who were randomised to receive a wearable cardioverter–defibrillator continuously (except while bathing) for three months in addition to guideline-directed therapy (n=1,524), or to receive guideline-directed therapy alone (n=778).
The authors found the wearable defibrillator did not lead to a significantly lower rate of arrhythmic death during the first 90 days, with arrhythmic death occurring in 1.6 per cent of participants in the device group and in 2.4 per cent of those in the control group (P=.18).
Overall, 20 participants in the device group received an appropriate shock and nine received an inappropriate shock.
Participants wore the device for a median of 18.0 hours per day, with decreasing use over time. The authors suggested nonadherence to wearing the device may have reduced the power of the trial.