{
  "abstract": "Background Sudden cardiac death (SCD) is a common cause of cardiovascular mortality, often triggered by ventricular arrhythmias in the setting of myocardial vulnerability. The wearable cardioverter-defibrillator (WCD) offers temporary protection against SCD, particularly when an implantable device is contraindicated or premature.Objectives We conducted a comprehensive meta-analysis to assess the effectiveness of the WCD in appropriately terminating life-threatening arrhythmias such as sustained ventricular tachycardia (VT) and ventricular fibrillation (VF), preventing sudden cardiac death.Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically reviewed 40 studies comprising 59 647 adults fitted with a WCD for primary or secondary SCD prevention. Random-effects meta-analysis, subgroup analysis, meta-regression and sensitivity analyses were performed.Results The pooled incidence of appropriate WCD intervention was 3% (95% CI 2% to 3%), with substantial heterogeneity (I²=88.9%). The prediction interval ranged from 1% to 8%, indicating that future studies conducted in selected high-risk populations may observe significantly higher WCD intervention. Life-threatening arrhythmias were higher during early follow-up (≤60 days). An appropriate daily WCD wearing time significantly influenced the results. Gender, age, ejection fraction and study design were not significant modifiers. No publication bias was detected.Conclusions The WCD represents an effective strategy for preventing SCD in early high-risk settings, with its benefit closely linked to adherence and appropriate patient selection.",
  "authors": [
    {
      "affiliations": [
        "Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, Rome, Italy",
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Lazio, Italy"
      ],
      "name": "Andrea Matteucci"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Lazio, Italy"
      ],
      "name": "Michela Bonanni"
    },
    {
      "affiliations": [
        "Department of Cardiology, Regional General Hospital “F.Miulli’, Bari, Italy"
      ],
      "name": "Luca Sgarra"
    },
    {
      "affiliations": [
        "Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, Rome, Italy"
      ],
      "name": "Carlo Pignalberi"
    },
    {
      "affiliations": [
        "Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, Rome, Italy"
      ],
      "name": "Stefano Aquilani"
    },
    {
      "affiliations": [
        "Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, Rome, Italy"
      ],
      "name": "Stefania Angela Di Fusco"
    },
    {
      "affiliations": [
        "Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, 'Sapienza' University of Rome, Rome, Italy"
      ],
      "name": "Marco Valerio Mariani"
    },
    {
      "affiliations": [
        "Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, 'Sapienza' University of Rome, Rome, Italy"
      ],
      "name": "Nicola Pierucci"
    },
    {
      "affiliations": [
        "Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, 'Sapienza' University of Rome, Rome, Italy"
      ],
      "name": "Carlo Lavalle"
    },
    {
      "affiliations": [
        "Department of Interventional Cardiology, Ospedale Sandro Pertini, Rome, Lazio, Italy"
      ],
      "name": "Silvio Fedele"
    },
    {
      "affiliations": [
        "Santo Spirito Hospital, Casale Monferrato, Italy"
      ],
      "name": "Federico Nardi"
    },
    {
      "affiliations": [
        "Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, Rome, Italy"
      ],
      "name": "Furio Colivicchi"
    }
  ],
  "title": "Wearable cardioverter defibrillator for transient arrhythmic risk and sudden cardiac death prevention: a systematic review and updated meta-analysis",
  "uid": "7d55039e-453e-53bd-9768-38916cc22023"
}