Impact on mortality
The mortality rate was similar between both genders in our multicenter
register. For this purpose, one large trial investigating gender
differences after ICD showed no differences in the mortality rate
between males and females during follow-up [17]. In the United
States (US) registry, WCD use reduced the rate of mortality up to 67%
reduction analyzed with the propensity-score-matching method [24].
In this trial, 19% of all participants were female and
3-month-mortality was 2.2% in all patients. In the VEST trial, the
mortality rate was 3.1% at 3 months [8]. These rates are less than
in our trial, but our follow-up time is longer as compared to
US-registry and VEST trial. In addition, the VEST trial had high
selected exclusion criteria as compared to our real-world experience.
To summarize, in a real-world setting, we do not observe any differences
in adherence, efficacy, and impact on mortality in male and female
patients after WCD use. The improvement of LVEF was observed in both
groups. However, LVEF improved more in adult than in older patients.