176-46: Indications for the use of the wearable cardioverter defibrillator – the Austrian LifeVest Registry

Introduction: The wearable cardioverter-defibrillator, WCD; LifeVest©) is a treatment option for patients at high risk for VT/VF, either in whom this risk may be temporarely or in whom an ICD implanation is currently not possible. Methods: Retrospective registry of all patients in Austria who received a WCD 2010-2015. Results: 226 Austrian patients (62 ± 13 years; 25% female) received a WCD. Main indications were: Newly diagnosed severe cardiomyopathy (30%), ischemic cardiomyopathy with recent PCI (22%), recent myocardial infarction (19%), delayed ICD implantation (13%), acute myocarditis (10%), ICD-associated infection (6%). Left ventricular EF was 40 ± 14%, median CHA2DS2VASc-Score 3 (2–5). 51% of patients had VT/VF before the WCD period. The median WCD duration was 58 (1–380) days. There was no difference in WCD compliance between patients wearing the WCD <60 days vs. >60 days (23 (3–24) h/day vs. 22 (1–24) h/day; n.s.). 9 patients (2,6%) received adequate WCD shocks for VT/VF, terminating the arrhythmia to sinus rhythm. All 9 patients received an ICD. No inadequate shocks occured. Only 51% of all 226 patients required ICD implantation after the WCD. Of the 9 patients with myocarditis, only one patient (11%) required an ICD. Conclusion: The WCD is an effective treatment option in patients at high risk for VT/VF and/or in whom ICD implantation is temporarely not possible. Only 51% of patients require an ICD after the WCD period.