Why the study?
Current guidelines do not cover the routine use of WCDs in syncope, and the role of an external defibrillator in patients with syncope lacking clear FDA indications remains open to discussion.
This case highlights the potential utility of a wearable cardioverter-defibrillator in a patient with recurrent syncope and suspected malignant arrhythmia who did not meet standard FDA indications.
wearable cardioverter-defibrillator (WCD) (Zoll Medical Corp., Chelmsford, MA, USA) and scheduled to undergo cardiac magnetic resonance imaging (MRI) with gadolinium enhancement at a tertiary center. However, before the scheduled MRI scan could be performed, she developed tachycardia, for which the WCD alarmed. A dual-chamber implantable cardioverter-defibrillator was subsequently implanted. Assessment of a patient with syncope requires consideration of the idea that a life-threatening and recurrent arrhythmia may be a cause for the problem. However, current guidelines do not cover the routine use of WCDs in syncope. Additionally, the patient described here did not clearly meet United States Food and Drug Administration indications for the provision of an external defibrillator. We present this case to provoke discussion among colleagues regarding this patient's treatment plan.
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Johnston et al. (2019) studied this question.
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