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

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Sudden cardiac death (SCD) remains a significant concern in various patient populations.
• Wearable cardioverter defibrillators (WCD) offer a non-invasive option for arrhythmia monitoring and treatment.
• Understanding appropriate indications and limitations of WCDs is crucial for optimal patient care.

Purpose of the Study:

• To review current data on indications for WCD use.
• To discuss the limitations and findings of key trials, such as the VEST trial.
• To explore potential and existing WCD applications in diverse patient groups.

Main Methods:

• Systematic literature search of PubMed, Google Scholar, and Cochrane Central Register.
• Review of randomized controlled trials, focusing on the VEST trial.
• Analysis of evidence supporting various WCD indications.

Main Results:

• The VEST trial did not demonstrate statistically significant utility of WCDs in post-myocardial infarction patients with low ejection fraction.
• Despite negative findings in the VEST trial, WCDs show promise in specific patient subsets.
• Potential benefits exist for patients with decreased left ventricular function, severe cardiomyopathy, awaiting transplant, or with temporary device removal.

Conclusions:

• WCDs are a novel tool for managing life-threatening arrhythmias in select high-risk patients.
• While not universally beneficial, WCDs have established and emerging roles in specific cardiovascular conditions.
• Further research is needed to fully elucidate the scope and efficacy of WCDs across different patient populations, including pediatric, peripartum, and dialysis patients.