ORLANDO (Mar 10, 2018) - Wearing a lightweight vest equipped with a cardioverter defibrillator that detects abnormal heart rhythms in addition to taking recommended medications is associated with a reduction in the likelihood of dying during the first 90 days following a heart attack in people whose heart function was also impaired, according to a study presented at the American College of Cardiology's 67th Annual Scientific Session. People who wore the wearable cardioverter defibrillator (WCD) during the study timeframe were 35 percent less likely to die for any reason compared with those who received medications alone.
While the study did not find a significant benefit in terms of reducing sudden cardiac death, the primary endpoint, the study did find that the wearable defibrillator was associated with fewer overall deaths.

"It is possible that sudden deaths were misclassified as it's difficult to define sudden death with accuracy when a death is unwitnessed and there is little documentation," said Jeffrey E. Olgin, MD, professor and chief of cardiology, University of California San Francisco and lead author of the study. "But the cause of death is irrelevant if we can prevent it. This study found that the device was associated with fewer deaths among people recovering from a heart attack with low ejection fraction. It's also the first therapy associated with a mortality benefit above and beyond standard medical therapy immediately after heart attack."

The Vest Prevention of Early Sudden Death Trial (VEST) is the first randomized, controlled, multi-center trial of the wearable cardioverter defibrillator. It was designed to test whether this device could effectively reduce sudden death in patients who had recently suffered a heart attack and had reduced heart function (defined as a low ejection fraction of 35 percent or less) where the heart wasn't able to pump sufficient blood to the rest of the body, which is indicative of a sizable heart attack.

Generally, the three-month mortality rate for people recovering from a heart attack who also have reduced heart function is around 5 percent, Olgin said, and that is with optimal medical management. Similarly, in VEST, 4.9 percent of participants in the control group died compared with only 3.2 percent of those wearing the WCD–an absolute difference of 1.7 percent.

"There is a very high risk of death immediately after a heart attack that tails off after about three months," Olgin said. "The challenge is that we don't currently have a good way of preventing deaths during this very vulnerable period."

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