Wearable Defibrillator Fails to Reduce Arrhythmic Death Early After MI

In the first few weeks after myocardial infarction (MI), preventing sudden death has been challenging, with two randomized, controlled trials of implantable cardioverter–defibrillators (ICDs) in early post-MI showing no benefit. Nevertheless, researchers have sought to determine whether a wearable defibrillator, in the VEST trial (sponsored initially by NIH and then by the manufacturer), would reduce sudden death mortality. The trial randomized 2302 post-MI patients with left ventricular ejection fraction ≤35% and who were receiving medical therapy (NCT01446965). The primary outcome was subsequently changed to sudden death and nonsudden death due to ventricular tachyarrhythmias (though it is not listed that way on ClinicalTrials.gov).

The pr…