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Recent Updates in the Role of Wearable Cardioverter Defibrillator for Prevention of Sudden Cardiac Death

  • Arrhythmia (R Kabra, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

The wearable cardioverter defibrillator (WCD) or LifeVest may protect against sudden cardiac death (SCD) in patients awaiting insertion of an implantable cardioverter defibrillator (ICD). The purpose of this communication is to review the rationale behind WCD therapy and to critically analyze recent data regarding its clinical efficacy. We seek to provide evidence-based recommendations regarding the potential role of the WCD in certain populations.

Recent findings

The only randomized controlled trial that evaluated WCD therapy did not demonstrate a reduced rate of arrhythmic death in patients prescribed the WCD during the first 90-day post-myocardial infarction (MI). However, when considering trial results alongside previous retrospective data, patient noncompliance with WCD therapy—rather than ineffectiveness of WCD therapy—remains an important theme.

Summary

The uncertainty of data regarding the use of WCD therapy in patients during ICD waiting periods should be considered as part of the shared decision processes between healthcare providers and patients. Higher rates of adherence are needed to ensure efficiency. Well-designed future studies with appropriate cost-effectiveness analyses are indicated to define the clinical efficacy of WCD therapy on arrhythmic and non-arrhythmic morbidity and mortality in patients who are not yet candidates for ICDs.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiovascular Diseases, Cardiovascular Institute, Methodist Le Bonheur Healthcare System, University of Tennessee Health Science Center, Memphis, TN, USA

    Irene Kirolos MD, MPH, David Jones MD, Kirstin Hesterberg DO, Charles Yarn BA, Rami N. Khouzam MD & Yehoshua C. Levine MD

  2. Methodist le Bonheur Healthcare, Division of Cardiology, University of Tennessee Health Science Center, 1211 Union Avenue, Suite 475, Memphis, TN, 38104, USA

    Yehoshua C. Levine MD

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  1. Irene Kirolos MD, MPH
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  2. David Jones MD
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Correspondence to Yehoshua C. Levine MD.

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Kirolos, I., Jones, D., Hesterberg, K. et al. Recent Updates in the Role of Wearable Cardioverter Defibrillator for Prevention of Sudden Cardiac Death. Curr Treat Options Cardio Med 21, 49 (2019). https://doi.org/10.1007/s11936-019-0746-z

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