A Tale of Two "Unexpected" Asystoles
Giacomo Mugnai1, Bruna Bolzan1, Elena Franchi1
1Division of Cardiology, Cardio-Thoracic Department, University Hospital of Verona, 37126 Verona, Italy.
Journal of Cardiovascular Development and Disease
|July 25, 2025
Summary
Wearable and subcutaneous cardioverter-defibrillators can detect unexpected asystoles. Patients with conduction disorders may need backup pacing alongside these devices.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Wearable cardioverter-defibrillators (WCD) and subcutaneous implantable cardioverter-defibrillators (ICD) are crucial for managing tachyarrhythmias.
- These devices primarily focus on detecting and treating fast heart rhythms.
Observation:
- Two cases of prolonged, unexpected asystoles occurred in patients with WCD and subcutaneous ICD.
- These bradyarrhythmic events were promptly identified and managed.
Findings:
- While WCD and ICDs excel at managing tachyarrhythmias, they lack pacing capabilities.
- This highlights a potential risk for patients with underlying paroxysmal conduction disorders.
Implications:
- It is essential to identify patients who may require backup pacing in conjunction with WCD or ICD therapy.
- Utilizing the monitoring features of these devices to detect bradyarrhythmias is critical for comprehensive patient care.
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