The Wearable Cardioverter Defibrillator-Bridge to the Implantable Defibrillator.

The wearable cardioverter defibrillator (WCD) was introduced into clinical practice about 8 years ago as an alternative approach to protect patients with a temporary high risk of sudden arrhythmic death. The WCD has the characteristics of an implantable defibrillator (ICD) but does not need to be implanted, and it has similarities with an external defibrillator, but does not require a bystander to apply lifesaving shocks when necessary. Based on current clinical experience, the WCD is not an alternative to the ICD, but a device that will contribute to better selection of patients for ICD therapy and may be indicated in case of interrupted protection by an already implanted ICD, temporary inability to implant an ICD, or refusal of an indicated ICD.

Bridging a temporary high risk of sudden arrhythmic death. Experience with the wearable cardioverter defibrillator (WCD).

The implantable cardioverter defibrillator (ICD) is able to reduce sudden arrhythmic death in patients who are considered to be at high risk. However, the arrhythmic risk may be increased only temporarily as long as the proarrhythmic conditions persist, left ventricular ejection fraction remains low, or heart failure prevails. The wearable cardioverter defibrillator (WCD) represents an alternative approach to prevent sudden arrhythmic death until either ICD implantation is clearly indicated or the arrhythmic risk is considered significantly lower or even absent.