Gender differences and adherence of patients treated with wearable
cardioverter-defibrillator: insights from an international multicenter
register
Abstract
Aims The treatment with the wearable cardioverter defibrillator
(WCD) may protect against sudden cardiac death (SCD) as a bridging
therapy until a cardioverter-defibrillator may be implanted. We analyzed
in a multicenter setting a consecutive patient cohort wearing WCD to
explore gender differences. Methods and results We analyzed 708
consecutive patients, 579 from whom were males and 129 females (age,
60.5±14 vs. 61.6±17 years old; p=0.44). All patients were divided into
age quartiles for analysis. 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=0.001), females
received it more frequently due to non-ischemic cardiomyopathy (NICM)
(55.8% vs. 42.7%); p=0.009). The wear time of WCD was equivalent in
both groups (21.1±4.3 hours/days in males vs. 21.5±4.4 hours/days in
females; p=0.27; and 62.6±44.3 days in males vs. 56.5±39 days in
females; p=0.15). Mortality was comparable in both groups at
2-year-follow-up (6.8% in males vs. 9.7% in females; p=0.55).
Appropriate WCD shocks and the incidence of device implantations were
similar in both groups (2.4% in males vs. 3.9% in females; p=0.07)
(35.1% in males vs. 31.8% in females; p=0.37), respectively. In age
quartile analysis, compliance was observed more in older patients as
compared to adult patients (87.8% vs. 68.3%; p<0.001).
Conclusion Compliance for wearing WCD was excellent regardless
of gender. Furthermore, mortality and the incidence of device
implantations were comparable in both groups. Appropriate WCD shocks
tended to be higher in females as compared to males.