Sudden cardiac death in newly diagnosed non-ischaemic or ischaemic cardiomyopathy assessed with a wearable cardioverter-defibrillator: the German nationwide SCD-PROTECT study

作者：David Duncker, Éloi Marijon, Marco Metra, Olivier Piot, Marat Fudim, Uwe Siebert, Norbert Frey, Lars S. Maier, Johann Bauersachs · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf668 · 被引用次数：22 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac electrophysiology and arrhythmias、Cardiac Imaging and Diagnostics

BACKGROUND AND AIMS: Patients with newly diagnosed non-ischaemic cardiomyopathy (NICM) or myocardial infarction/coronary artery disease (MI/CAD) face an increased risk of sudden cardiac death (SCD) during the early phase of guideline-recommended medical therapy initiation and up-titration. Aim is to evaluate the risk in this population by assessing sudden cardiac arrest (SCA) due to ventricular tachycardia/ventricular fibrillation (VT/VF). METHODS: All patients in Germany who received a wearable cardioverter-defibrillator (WCD) between December 2021 and May 2023 were enrolled in the observational multicentre SCD-PROTECT study (NCT06883383). The primary outcome was the incidence of SCA due to sustained VT/VF, measured by appropriate WCD-delivered treatments, and reported as events per 100 patient-years with 95% confidence intervals (CI). Secondary outcomes included inappropriate WCD treatments, all-cause mortality, adverse events, adherence to WCD use, and heart failure medication patterns. RESULTS: In this cohort of 19 598 patients, the mean age (±standard deviation) was 58.6 ± 13.7 years for those with NICM and 64.2 ± 10.6 years for patients with MI/CAD. Female patients accounted for 23.8% of the NICM and 16.3% of the MI/CAD group. Left ventricular ejection fraction (LVEF) at study start was 26.9 ± 10.3% for NICM and 28.4 ± 8.0% for MI/CAD patients. The incidence rate of first appropriate treatment by WCD in NICM patients and MI/CAD patients was 6.10 (95% CI 5.31-7.00) and 8...