Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Age-differences of patients treated with wearable cardioverter defibrillator: data from a multicenter Registry
I. El-Battrawy1, D. Tenbrink1, B. Kovacs2, T. Dreher3, R. Hemetsberger1, N. Klein4, S. L. Rosenkaimer5, S. Röger5, A. M. Saguner2, J. Kowitz3, J. W. Erath-Honold6, F. Duru2, A. Mügge1, I. Akin5, A. Aweimer1
1Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftlliches Universitätsklinikum Bergmannsheil, Bochum; 2Unispital Zürich, Zürich, CH; 3Universitätsklinikum Mannheim, Mannheim; 4Klinik für Kardiologie, Angiologie und intern. Intensivmedizin, Klinikum Sankt Georg, Leipzig; 5I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 6Med. Klinik III - Kardiologie Zentrum der Inneren Medizin, Universitätsklinikum Frankfurt, Frankfurt am Main;

Background
Wearable cardioverter defibrillators (WCD) are important to avoid immediate implantable cardioverter defibrillator (ICD) implantation in patients, who are at high risk of sudden cardiac death (SCD). Different factors should be taken into consideration e. g. patient selection, compliance and optimal drug treatment. We aimed to present real world data from 6 centers from Germany and Switzerland according to age differences.

Material and Methods
Between 04/2012 and 03/2021, 893 patients were included in this registry. Outcome data according to age-differences (old≥45 compared to young<45 years) were analyzed. At young age were WCDs more prescribed due to non-ischemic cardiomyopathy (NICM), congenital disease and myocarditis. On the other hand, ischemic cardiomyopathy (ICM) were significantly more presented and the cause for WCD prescription in old patients. Wear days of WCD was similar between young and old patients (p=0.172). In addition, during the WCD use documented arrhythmic life-threatening events were comparable (7.3% versus 7.1%) and consequently the rate of appropriate shocks was similar between both groups. In both groups left ventricular ejection fraction improvement was documented at 3 months of follow-up and 6-12 months of follow-up with a better improvement in young patients compared to old patients. In old patients more late-gadolinium-enhancement (LGE) was documented related to ICM and NICM (p=0.01). The rate of permanent ICD implantation was significantly lower in young patients compared to old patients (23,2% versus 37.5%, p<0.001). The compliance rate defined as wearing WCD at least 20 hours per days was significantly lower in young patients compared to old patients (68,9% versus 80,9%, p=0.004). However, during the WCD use no significant differences regarding death and/or arrhythmic death was shown in young patients compared to old patients.

Conclusion
The most common indication for WCD was myocarditis, NICM and congenital diseases in young patients and ICM in old patients. In young patients more ICD implantations could be avoided compared to old patients. However, the compliance rate of WCD use might be less in young patients compared to old patients.
https://dgk.org/kongress_programme/jt2022/aV984.html