The prospective cohort study was conducted between 2022 and 2024 and included 41 patients with an average age of 59 years. The most common diagnoses were:
The indication for the wearable cardioverter defibrillator (WCD) was based on the guidelines of the European Society of Cardiology (ESC) and the Italian Association of Cardiologists (ANMCO). The WCD system consisted of a vest with four ECG electrodes and three defibrillation pads connected to a battery-powered monitor.
In addition to regular checkups, data on heart rhythm, physical activity, and duration of wear were recorded, and the patients' medical treatment was individually adjusted based on the WCD data obtained. In addition, a weekly 6-minute walk test was integrated into the WCD measurement to assess progress in physical endurance. In addition, the subjects completed questionnaires documenting both quality of life and symptoms.
During the average follow-up period of 62 ± 38 days, participants demonstrated high compliance: The WCDs were worn for an average of 22.7 hours per day. Furthermore, weekly walking tests and questionnaires showed a trend toward improvement in physical performance and symptoms.
Twelve percent of patients experienced transient ventricular arrhythmias, but no persistent events requiring treatment.
A particularly important finding of the study: By providing a WCD, permanent defibrillator implantation could be avoided in 69% of subjects. The remaining subjects who ultimately required an ICD were predominantly those with HFrEF. In study participants with acute coronary syndrome, however, the ejection fraction usually improved significantly over time, so that an ICD was no longer necessary.
WCDs have proven to be a safe and effective interim solution in the presented study. Their use is particularly worthwhile in cases where continuous monitoring is not required and where cardiac function can improve over time. In the cohort studied, ICD implantation was avoided in almost 70% of cases.