Wearable Cardioverter-Defibrillators

Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death

“…These characteristics of the WCD, along with safety and efficacy data presented to the US Food and Drug Administration (FDA), resulted in approval in the United States in 2002. 8 Because of the increasing use of the WCD and uncertainty of indications among practicing cardiovascular health professionals, this science advisory was prepared by the American Heart Association. In this advisory, we describe the WCD in the context of its unique technology, clinical niche, and alternative therapies.…”

How Should We Use the Wearable Cardioverter-Defibrillator in Japan?

“…However, neither has been reported in the clinical trials performed so far. 2 Although one of the main concerns about the WCD was compliance, the actual time of wearing of the device by the patient can be automatically collected by the device. Another concern is the ability of patients to use the device correctly.…”

“…Main errors are placement of the electrodes and refraining from pressing the response button by conscious patients. 2 Sleep disturbance caused by false alarms occurred in approximately half of the reports. However, only 5% of patients discontinued its use.…”

“…Because there are no randomized or controlled trials studying the survival benefit with WCD, guidelines for its use are quite general and its prescription often relies on expert opinion. 2 Thus, there are differences in the frequency of various indications reported from Germany 3 and the United States. 11 The main reasons for WCD use in Germany are recent MI (39%), post coronary artery bypass grafting (25%), ICD explant (10%), and myocarditis and non-ischemic cardiomyopathy (NICM; 10%).…”

“…11 The main reasons for WCD use in Germany are recent MI (39%), post coronary artery bypass grafting (25%), ICD explant (10%), and myocarditis and non-ischemic cardiomyopathy (NICM; 10%). 2 In the USA, they are ICD explant (23%), NICM (20%) and delay in implantation (16%). 11 Sasaki et al 1 reported that the underlying heart diseases were prior MI (3 recent and 2 previous MI), variant angina, fulminant myocarditis, cardiac amyloidosis, and idiopathic VF (1 each).…”