Wearable
cardioverter defibrillators (WCD), initially available in 2002, have recently experienced
more routine use in many institutions as a means of preventing sudden cardiac
death (SCD) prior to implantable cardioverter defibrillator (ICD) evaluation or
implantation. WCD differ from ICD by their noninvasive nature, making them well
suited for patient populations who have a chance for significant cardiac
recovery (such as after an acute myocardial infarction).
Despite
their noninvasive nature, WCD treatment of sustained ventricular
tachyarrhythmias is highly successful. An additional feature is the use of
response buttons, which reduces the number of conscious shocks. Duration of use
varies by condition but is typically several weeks to several months. Numerous
studies have shown good compliance with WCD use and excellent efficacy.
Although few prospective studies have been published, several are in
progressive including a randomized control trial of high risk patients after
myocardial infarction.
WCD
use is rapidly gaining popularity for patients with recent myocardial
infarction, recent-onset cardiomyopathies, and acute or subacute myocarditis. Surgical
delays in implanting an indicated ICD or after ICD removal are also common. WCD
removal occurs when the patient either qualifies for an ICD implantation or is
determined to no longer have elevated SCD risk.
Credits: Priv.-Doz. Dr. Johannes Sperzel