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Wearable Cardioverter Defibrillator (WCD) in Belgium
The webinar focuses on preventing sudden cardiac death (SCD) in Belgium,
particularly in patients recovering from acute myocardial infarction (MI) and
those with newly diagnosed HFrEF. For post-MI patients with low ejection fraction (≤35%), the immediate period after MI carries the highest SCD risk, with wearable cardioverter defibrillators (WCDs) showing effectiveness in reducing arrhythmic deaths. In newly diagnosed HFrEF, early WCD use during optimal medical therapy initiation is crucial, with potential for recovery or transition to permanent ICDs after stabilization. Clinical cases underscore the practical integration of WCDs in managing both acute MI and chronic HFrEF effectively.
01
The faculty addresses incidence of SCD in Belgium, with 10,000 to 17,000 cases annually primarily linked to coronary artery disease in older adults, and around 2,000 deaths per year in younger individuals due to electrical disorders and cardiomyopathies. Assessing individual risk profiles, deciding optimal timing for ICD placement, and exploring strategies to potentially reduce the need for permanent ICDs in primary prevention efforts is discussed.
02
Preventing SCD in CAD patients and after acute MI with reduced ejection fraction is discussed, focusing on early left ventricular function assessment, optimal medical therapy initiation, and the potential of wearable defibrillators in these high-risk individuals, especially within the first 30 days.
03
The effective use of the LiveVest wearable cardioverter defibrillator (WCD), in treating a 65-year-old male patient with acute coronary syndrome and ischemic cardiomyopathy is presented. Following bypass surgery and medical
management of ventricular arrhythmias, the patient's condition improved, leading to the successful discontinuation of the WCD without any detected alarms or arrhythmias during its use.
04
The case of a 62-year-old taxi driver is detailed who suffered an anterior ST-elevation myocardial infarction (STEMI) and underwent emergency angioplasty with stenting due to proximal LAD occlusion. Complications such as cardiogenic shock and arrhythmias led to the temporary use of a WCD for protection from SCD. After a month of intensive medical treatment, significant improvement in cardiac function was observed, allowing for the discontinuation of the WCD.
05
The efficacy of WCDs in preventing sudden cardiac death among post-MI patients during the critical 30-day period following myocardial infarction is highlighted. The device's safety and its role in risk assessment as patients undergo treatment to improve left ventricular function is emphasized. Additionally, the potential for a significant portion of patients to transition away from needing a permanent ICD over time is discussed.
06
This clip focuses on preventing SCD in heart failure patients by highlighting the predictive role of left ventricular ejection fraction. It discusses how optimal medical therapy (OMT) improves heart function and reduces mortality over 3 to 6 months. WCDs are suggested as a temporary protective measure during this critical period while evaluating the necessity for a permanent ICD
07
The video discusses the benefits of WCDs for high-risk cardiac patients, noting the highest risk is in the first 30 days, but benefits persist beyond.
Close monitoring tracks ejection fraction improvements to guide discontinuation. Also potential reimbursement for telemonitoring services, stressing personalized strategies for cost-effectiveness and patient outcomes are mentioned.