Comments on the authors’ reply to the critical appraisal concerning “Wearable cardioverter defibrillators for the prevention of sudden cardiac arrest: a health technology assessment and patient focus group study”

Abstract

Johannes Sperzel,1 Ingo Staudacher,2 Olaf Goeing,3 Martin Stockburger,4 Thorsten Meyer,5 Ana Sofia Oliveira Gonçalves,6 Hanna Sydow,6 Tonio Schoenfelder,6 Volker Amelung6 1Department of Cardiology, Hospital Kerckhoff Klinik GmbH, Bad Nauheim, Germany; 2Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany; 3Department of Cardiology, Sana-Hospital Lichtenberg, Berlin, Germany; 4Medical Department I, Havelland Kliniken GmbH, Nauen, Germany; 5Department of Public Health, Universität Bielefeld, Bielefeld, Germany; 6inav – privates Institut für angewandte Versorgungsforschung GmbH, Berlin, GermanySince the authors’ reply to our critical appraisal did not properly address the points we raised, we still see need for further clarification. The wearable cardioverter defibrillator (WCD) is not an adequate substitute for an implantable cardioverter defibrillator (ICD). The authors state that both can be compared immediately post-myocardial infarction (MI). According to the current guidelines, primary prevention of sudden cardiac death with the ICD within 40 days after MI is generally not indicated.1 Therefore, we disagree with the authors’ proposal of conducting such a trial. In this context, the authors mentioned the VEST trial, which compares a WCD population and one receiving medical treatment. There is explicitly no comparison to an ICD population.View the original paper by Sperzel and colleagues.

Keywords

• sudden cardiac arrest
• wearable cardioverter defibrillators
• ICD
• WCD
• health technology assessment