A review on wearable cardioverter-defibrillators in clinical practice for sudden cardiac death prevention and heart failure management

Sudden cardiac death (SCD) remains a predominant mode of death in cardiovascular mortality. Despite advancements in guideline-recommended medical therapy and risk stratification, accurately identifying patients who would benefit most from implantable cardioverter-defibrillator (ICD) therapy over the long term remains a significant challenge. The wearable cardioverter-defibrillator (WCD) has emerged as a non-invasive bridge to either ICD implantation or recovery of left ventricular function. This expert review presents a comprehensive and up-to-date summary of clinical evidence on WCD use for SCD prevention and heart failure (HF) management. Specifically, it will address: (i) the concept and mechanism of the WCD; (ii) evidence from randomized and observational studies regarding efficacy, safety, and cost-effectiveness; (iii) integration of the WCD into HF management; and (iv) knowledge gaps and priorities for future research.