[The wearable cardioverter defibrillator - temporary protection against sudden cardiac death]

Ventricular tachycardia or ventricular fibrillation can be terminated by defibrillation and implantable cardioverter defibrillators (ICDs) prevent sudden cardiac death. Since 2001 the wearable cardioverter defibrillator (WCD) has been available to provide temporary protection; it safely and effectively detects and terminates ventricular tachyarrhythmias. VEST (published in 2018) compared the effect of WCD in patients with ejection fraction ≤35 percent following myocardial infarction. Total mortality was reduced but sudden cardiac death did not reach statistical significance. According to European guidelines a WCD could be used to protect patients during the time they are evaluated for ICD; for example, during the three-month period with optimal medical therapy awaiting recovery of a low ejection fraction. It could also be considered during the period following extraction due to endocarditis before reimplantation of ICD or during the waiting period for heart transplant.