VEST Trial: Wearable Cardioverter–Defibrillator after MI

Why did researchers conduct the VEST trial?

The researchers carried out the VEST trial (Wearable cardioverter-defibrillator after myocardial infarction) to find out if wearable cardioverter-defibrillators (WCDs) reduce arrhythmic death compared to medical therapy in patients with ischemic cardiomyopathy (LVEF ≤35%) due to acute myocardial infarction (MI).

Who was in the trial?

This was a large multicenter trial that took place at 76 hospitals in the United States, and European countries. Researchers screened thousands of patients to see if they could take part in the study. Patients were included if they were hospitalized with an MI and had an ejection fraction of 35% or less (assessed ≥8 hours after MI). For patients who had undergone revascularization, the LVEF was assessed 8 or more hours after PCI or 48 or more hours after CABG. Over the course of 9 years, the researchers recruited over 2,348 patients and eventually 2,302 were randomly assigned to 1,524 vest group and 778 patients were assigned to the control group.

What did the researchers find?

Wearable cardioverter-defibrillator did not result in improved outcomes when compared to control group. Arrhythmic death in the vest group was occured in 1.6% patients compared to 2.5% in patients in the control group (P=0.18). The total mortality was 3.1% in the vest group, as compared with 4.9% in the control group (P=0.04).