ArticleESC heart failure2024
Wearable defibrillator to improve accuracy in selecting candidates to implantable defibrillator: A real-world experience.
Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Wearable Cardioverter-Defibrillator in Patients at Transient Risk of Sudden Cardiac Death: State of the Art and Contemporary Clinical Evidence.Diagnostics (Basel, Switzerland) · 2026Review
- Variabiliy in Prescribing Patterns of Wearable Cardiac Defibrillators: Current Data, Guidelines, Challenges, and Controversies.Current cardiology reports · 2025Review
- Wearable defibrillator to improve accuracy in selecting candidates to implantable defibrillator: A real-world experience.ESC heart failure · 2024Article
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Authors and funding
13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimsThe indication for implantable cardioverter defibrillator (ICD) for sudden cardiac death (SCD) prevention relies mostly on left ventricular ejection fraction (LVEF) ≤ 35%. The use of a wearable cardioverter defibrillator (WCD) in the case of dynamic alterations of LVEF may help avoid an improper early ICD implant when a favourable evolution in the post-acute phase is observed and may help reduce costs.
methodsThis parallel cohort retrospective study included patients with heart failure with reduced ejection fraction (HFrEF) at high risk of arrhythmias recruited in the acute phase and divided into an early ICD cohort and a WCD cohort for primary prevention during the waiting period established by European Society of Cardiology guidelines.
resultsA total of 41 consecutive patients were enrolled: 26 in the WCD group and 15 in the early ICD group. Age, LVEF at baseline, causes of HFrEF and drug therapy in the two cohorts were similar. During the waiting period after the inclusion, three patients (11.5%) in the WCD cohort and four (26.7%) in the early ICD cohort developed relevant ventricular arrhythmias (P = 0.22); none of them had subsequent LVEF recovery. At the end of the waiting period, 13 patients (50%) in the WCD group and 7 (46.7%) in the early ICD group experienced LVEF recovery (P = 0.84). The average cost per patient at the end of the waiting period was €23 934 in the early ICD cohort versus €19 167 in the WCD cohort (-19.9%). This cost savings from WCD use appears even higher when projected over a 10 year period (-41.2%).
conclusionsWCD may represent a cost-effective strategy to more accurately select candidates for the primary prevention ICD implant among high-risk patients with HFrEF. ICD use provides effective protection from SCD and reduces costs compared with an extensive early ICD implant.
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