Who Should Receive a Wearable Defibrillator Vest at Hospital Discharge?

Curr Cardiol Rep. 2019 Sep 7;21(10):125. doi: 10.1007/s11886-019-1215-8.


Purpose of review: To discuss the role of wearable cardioverter defibrillator (WCD) vests in preventing sudden cardiac death (SCD) in at-risk populations.

Recent findings: The impact of randomized-controlled trials with implantable cardioverter-defibrillators (ICD) therapy is well established in randomized clinical trials in ischemic cardiomyopathy. Although the benefits are not as clear in non-ischemic cardiomyopathy, meta-analyses show significant mortality benefits from immediate electrical cardioversion strategies. The role of WCDs in at-risk populations in whom ICD therapy is temporarily not indicated is not as well-established. Smaller cohort trials have shown efficacy in patients with newly-diagnosed cardiomyopathy, requiring temporary ICD explantation, and others with less common indications for WCD therapy. The Vest Prevention of Early Sudden Death Trial was a landmark randomized control study seeking to examine the benefits of WCD therapy in at-risk population, and although the primary endpoint of reducing arrhythmic death was not reached, the structure of the trial and significant differences in total mortality make a compelling case for continued use of WCD therapies in our healthcare systems.

Keywords: Implantable cardioverter-defibrillator; Ischemic heart disease; Sudden cardiac death; Ventricular arrhythmias; Wearable cardioverter-defibrillator.

Publication types

  • Review

MeSH terms

  • Death, Sudden, Cardiac / prevention & control*
  • Defibrillators*
  • Defibrillators, Implantable*
  • Electric Countershock
  • Humans
  • Patient Discharge
  • Wearable Electronic Devices*