Misunderstood or Mistrusted? The Under-Utilization of the Wearable Cardioverter Defibrillator in Clinical Practice

Pooja S. Jagadish, Mariana Aziz, Viswanatha Chinta, Rami Khouzam

Research output: Contribution to journalArticle

Abstract

Annually in the United States, sudden cardiac death (including out-of-hospital cardiac arrests) is responsible for over 300,000 deaths, comprising 40%-50% of total mortality rates from cardiovascular disease. Among the highest-risk patients are those with ischemic and nonischemic cardiomyopathy who have a reduced left ventricular ejection fraction (≤ 35%-40%). However, not everyone is a candidate for an implantable cardioverter defibrillator. In 2002, the wearable cardioverter defibrillator (WCD) gained Food and Drug Administration approval for its efficacy in the prevention of sudden cardiac arrest or death in certain at-risk populations and has been making its way into national guidelines with Class IIa to IIb strength of evidence. Despite the prevalence of sudden cardiac death and the demonstrated efficacy of the WCD, this technology remains under-prescribed. This study seeks to explicate the potential causes for under-utilization of WCDs and offer means of overcoming barriers to its use. Among these reasons include confusion about the guidelines and when to prescribe, who can prescribe the device, and debate about whether the WCD is efficacious based on recent studies. Other social barriers to prescription include cost and adherence to therapy by the patient. This study sets the stage for further research on the improvement of education about the device and opens discourse about its prescription in clinical practice.

Original languageEnglish (US)
JournalCurrent Problems in Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

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Defibrillators
Sudden Cardiac Death
Prescriptions
Guidelines
Out-of-Hospital Cardiac Arrest
Drug Approval
Equipment and Supplies
Implantable Defibrillators
United States Food and Drug Administration
Cardiomyopathies
Stroke Volume
Cardiovascular Diseases
Technology
Education
Costs and Cost Analysis
Mortality
Research
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Misunderstood or Mistrusted? The Under-Utilization of the Wearable Cardioverter Defibrillator in Clinical Practice. / Jagadish, Pooja S.; Aziz, Mariana; Chinta, Viswanatha; Khouzam, Rami.

In: Current Problems in Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

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