The wearable cardioverter-defibrillator is needed for most high-risk patients.

▪ In VEST, post–myocardial infarction patients with low ejection fraction randomized to the WCD had nonsignificant decreases in arrhythmic and nonarrhythmic mortality and a nominally significant 36% decrease in overall mortality. ▪ When considering the WCD, we recommend shared decision making, which should include discussion of the nuances of the VEST findings, as well as the potential downsides of the WCD, such as alarms and discomfort.

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