Devices such as implantable cardioverter defibrillators (ICDs) and wearable cardioverter defibrillators (WCDs) have opened up new paths in the treatment of Sudden Cardiac Death. Guidelines advocate ICD placement for primary prevention after at least three months of optimal medical therapy following the first diagnosis of heart failure with reduced FE from any cause, and at least 40 days after an acute myocardial infarction with FE 35% notwithstanding medication. In these and other cases documented in the guidelines, the use of a wearable defibrillator (WCD), a noninvasive device that guards against malignant arrhythmias while waiting for arrhythmic risk to be defined and medication therapy to be optimized, may be considered. In our Cardiology/Utic Department, we treated 26 patients with a preliminary indication for ICD implantation: the use of the WCD allowed us to swiftly put them in clinical safety, avoiding potentially fatal arrhythmias while waiting for pharmacological therapy to be optimized. At the end of the periodic follow-up, FE had normalized in ten patients, allowing them to avoid ICD. Only 10 of the 26 participants with WCD had a proven indication for final implantation. There were no fatalities or problems in any of the patients.
Russo et al. (Tue,) studied this question.