Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 12, Number 2, February 2021, pages 49-53


Phantom Shocks Associated With a Wearable Cardioverter Defibrillator

Tables

Table 1. Indications for ICD Placement for Primary and Secondary Prevention of SCD [4]
 
aLVEF ≤ 35%, on maximal GDMT for at least 3 months and has intraventricular conduction delay of more than 120 ms. ICD: implantable cardioverter defibrillator; SCD: sudden cardiac death; MI: myocardial infarction; LVEF: left ventricular ejection fraction; NICM: non-ischemic cardiomyopathy; GDMT: goal-directed medical therapy; CRT: cardiac resynchronization therapy; BVICD: biventricular implantable cardioverter defibrillator; VT: ventricular tachycardia; VF: ventricular fibrillation.
Primary prevention of SCD
  MI within the past 40 days and LVEF ≤ 35%
  Patients with NICM with LVEF ≤ 35% after 3 months of optimized GDMT
  HF patients who are candidates for CRT with BVICDa
  Patients with congenital long QT syndrome with recurrent symptoms despite medical therapy
    High-risk patients with hypertrophic cardiomyopathy
    High-risk patients with Brugada syndrome, polymorphic VT and other channelopathies
Secondary prevention of SCD
  Prior episode of survived VF/VT or sustained hemodynamically unstable VT without an identifiable reversible cause
  Patients with episodes of spontaneously sustained VT in the presence of heart disease

 

Table 2. Indications for WCD Placement [5, 6]
 
WCD: wearable cardioverter defibrillator; NICM: non-ischemic cardiomyopathy; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; GDMT: goal-directed medical therapy; ICM: ischemic cardiomyopathy; ICD: implantable cardioverter defibrillator; MI: myocardial infarction; CABG: coronary artery bypass graft surgery; SCD: sudden cardiac death; MC: myocarditis; PPCM: peripartum cardiomyopathy; SIC: stress-induced cardiomyopathy; HFrEF: heart failure with reduced ejection fraction.
Patient populations
  Patients with NICM and LVEF ≤ 35%, NYHA class II-III less than 3 months of GDMT
  Patients with ICM and LVEF ≤ 35%, NYHA class II-III who cannot undergo ICD placement, within 40 days of MI or 90 days of a CABG procedure
  Patients awaiting ICD reimplantation after device infection or dislodgement
  Patients who are not good candidates for ICD or are not good surgical candidates
  Patients who prefer less invasive means for SCD prophylaxis
  Patients with a possibly reversible cause of reduced LVEF (MC, PPCM, SIC)
  Patients with terminal HFrEF awaiting to undergo cardiac transplant in near future