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Keeping up to date: a current review of wearable cardioverter defibrillator use.

Authors
  • Ashraf, Said1
  • Ilyas, Suleman2
  • Siddiqui, Fayez1
  • Ando, Tomo1
  • Shokr, Mohamed1
  • Panaich, Sidakpal1
  • Briasoulis, Alexandros1
  • Afonso, Luis1
  • Khan, Mazhar1
  • 1 Division of Cardiology, Detroit Medical Center/Wayne State University, Detroit, MI, USA.
  • 2 Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Type
Published Article
Journal
Acta cardiologica
Publication Date
Nov 05, 2019
Pages
1–10
Identifiers
DOI: 10.1080/00015385.2019.1682337
PMID: 31687917
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The introduction of wearable cardioverter defibrillators (WCD) provides a novel means of protection in select patients at high risk for sudden cardiac death. The WCD can safely record and terminate life-threatening arrhythmias. In this review, we explore the data behind indications for WCD use and discuss its limitations. We searched PubMed, Google Scholar and Cochrane Central Register of controlled trials for relevant studies. The VEST trial, the first randomised controlled trial on WCD use, did not show statistical significance in utility of the WCD in post-myocardial infarction patients with low ejection fraction. While the use of WCD in this select patient population showed no benefit, the findings of the trial merit closer inspection. Various other indications of WCD use still exist and others require exploration. Select subsets of patients who stand to benefit for other indications include severely decreased left ventricular function post-revascularization with high arrhythmic burden, severe non-ischaemic cardiomyopathy, patients awaiting heart transplant and patients who have had their implantable cardioverter device temporarily removed. The role of the WCD is also being explored in children, peripartum cardiomyopathy, haemodialysis patients, and in syncope secondary to high-risk arrhythmias.

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