[The Wearable Cardioverter-Defibrillator (WCD)].

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Implantable cardioverter-defibrillators (ICDs) are standard for long-term sudden cardiac arrest/sudden cardiac death (SCA/SCD) risk.
• Managing patients with temporary SCA/SCD risk, especially during waiting periods for ICD implantation, requires continuous monitoring.
• Current management strategies for temporary risk patients necessitate reliable, immediate lifesaving interventions.

Purpose of the Study:

• To evaluate the wearable cardioverter-defibrillator (WCD) as a solution for managing patients with temporary risk of SCA/SCD.
• To highlight the WCD's role in providing continuous monitoring and immediate defibrillation.
• To explore the WCD's application in specific patient populations awaiting definitive treatment or unable to receive ICDs.

Main Methods:

• The wearable cardioverter-defibrillator (WCD) is worn externally, featuring ECG and defibrillation electrodes integrated into a garment.
• The device allows for continuous cardiac event monitoring and retrospective analysis by physicians.
• The WCD system includes a defibrillation unit connected via a cord for immediate use.

Main Results:

• The WCD is a safe and effective method for terminating life-threatening ventricular arrhythmias like ventricular tachycardia and ventricular fibrillation.
• It is applicable in various clinical scenarios, including post-myocardial infarction with reduced ejection fraction and acute heart failure.
• The WCD serves patients awaiting heart transplantation, those with contraindications for ICDs, and those temporarily without an ICD post-explantation.

Conclusions:

• The wearable cardioverter-defibrillator (WCD) effectively addresses the need for continuous monitoring and on-demand treatment in patients with temporary risk of sudden cardiac arrest.
• Its versatility makes it suitable for a range of acute and transitional cardiac conditions.
• Risk stratification using WCD data may improve patient selection for long-term ICD therapy.