Role of the Wearable Defibrillator in Newly Diagnosed Heart Failure

Abstract

Purpose of review: The wearable defibrillator (WCD) was shown to be safe and effective in detecting and terminating ventricular tachyarrhythmias and therefore allows temporary protection from sudden cardiac death. This review gives an overview of the current data on WCD in newly diagnosed cardiomyopathy.

Recent findings: Patients with newly diagnosed heart failure and reduced LVEF appear to have an increased risk of ventricular tachyarrhythmias, which may decrease over time when heart failure medication is optimized and left ventricular function improves. This was shown to apply for patients with ischemic and non-ischemic cardiomyopathy, including peripartum cardiomyopathy. Prolongation of the WCD period may support to further optimization of heart failure medication, by protecting the patient from sudden cardiac death during this time and to avoid untimely ICD implantation. The WCD should be considered in structured patient management for newly diagnosed heart failure during the early phase of the disease. Careful patient selection, structured patient management, and patient's compliance is crucial for a successful WCD strategy.

Keywords: Heart failure; Newly diagnosed cardiomyopathy; Sudden cardiac death; Wearable defibrillator.

Fig. 1

Illustration of the course of left ventricular function after diagnosis of cardiomyopathy and the associated risk of ventricular tachyarrhythmia