Duncker David, Veltmann Christian
Rhythmology and Electrophysiology, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Curr Heart Fail Rep. 2018 Dec;15(6):368-375. doi: 10.1007/s11897-018-0415-7.
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.
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.
可穿戴式除颤器（WCD）已被证明在检测和终止室性快速心律失常方面是安全有效的，因此可为预防心源性猝死提供临时保护。本综述概述了新诊断心肌病患者使用WCD的当前数据。
新诊断的心力衰竭且左心室射血分数降低的患者似乎室性快速心律失常风险增加，在优化心力衰竭药物治疗且左心室功能改善后，该风险可能会随时间降低。这适用于缺血性和非缺血性心肌病患者，包括围产期心肌病患者。延长WCD使用期可能有助于进一步优化心力衰竭药物治疗，在此期间保护患者免受心源性猝死，并避免过早植入植入式心脏复律除颤器（ICD）。在疾病早期新诊断心力衰竭的结构化患者管理中应考虑使用WCD。仔细的患者选择、结构化的患者管理以及患者的依从性对于成功的WCD策略至关重要。
