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.