Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiac arrest in patients at risk. Update 2018

Chiarolla E, Orso M, Goetz G, Stanak M, Wild C, Jefferson T
Record ID 32018000335
Original Title: Tragbare Kardioverter Defibrillator Therapie zur Primär- und Sekundärprävention von plötzlichem Herzstillstand. Update 2018
Authors' objectives: Sudden cardiac arrest (SCA) is the most common cause of death in patients with coronary artery disease. In Europe, there are about 350 000 out of hospital SCAs per year. Mostly, ventricular tachycardia and ventricular fibrillation are the underlying aetiology of SCA. The wearable cardioverter defibrillator (WCD) –a novel defibrillation therapy– claims to prevent sudden cardiac deaths that may result from SCA. To date, it is unclear whether the plausible and promising theoretical benefits can be translated into clinically relevant benefits. Therefore, the project at hand aimed at synthesising the current available evidence regarding the use of the WCD
Authors' results and conclusions: The scientific evidence from 1 RCT indicates the WCD in combination with guideline-directed medical therapy (GDMT) is not proven to be more effective than GDMT alone based on the endpoint arrhythmic mortality. The studies included in the evaluation of safety of the device suggest that the WCD could be a relatively safe device.
Authors' recommendations: To date, the comparative effectiveness of the WCD was not established. Further research is needed in this context. This document is the German summary of a collaborative assessment due to be published in early 2019.
Authors' methods: A systematic review regarding the effectiveness and safety of the WCD was performed. In total, 11 studies were identified: 1 RCT was eligible for the evidence synthesis of the effectiveness of the WCD and further 10 observational studies were additionally included for the evaluation of safety of the device.
Project Status: Completed
Year Published: 2018
URL for additional information: http://eprints.aihta.at/1186/
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Defibrillators
  • Heart Arrest
  • Therapeutics
  • Tachycardia, Ventricular
  • Ventricular Fibrillation
  • Sudden cardiac arrest
  • ventricular tachycardia
  • ventricular fibrillation
  • (cardioverter-) defibrillator (external
  • wearable)
  • countershock
Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment
Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99
Contact Name: tarquin.mittermayr@aihta.at
Contact Email: office@aihta.at
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.