CONGRESS ABSTRACT

Background Worldwide sudden cardiac death (SCD) remains a major cause of death, despite the recent progress in prevention and interventions of cardiac disease. Implantable  cardioverter defibrillator (ICD) is an effective weapon for SCD prevention in high risk patients with reasonable expectation of survival.However in case of transient  risk of SCD, the use of a wearable cardioverter defibrillator(WCD) is considered in current guidelines . The purpose of this study was to investigate the safety and the adherence to WCD in a real world population; moreover we reviewed the rate of ICD implantation after WCD use. Methods We considered  consecutively 116 patients discharged from Piacenza cardiology department for potentially  transient high risk of SCD, weared a WCD from August  2017 to June  2024. The patients were discharged in high risk mode of SCD with WCD protection and followed through remote monitoring or outpatient.A clinical and echocardiographic evalutation was performed at baseline and at the end of the WCD use period. Results Out of 116 patients , with average age 65,8 ±11,1 years old and baseline average left ventricular ejection fraction  (LVEF) 29,9±8,9,  76,7% were males, 71,6% suffered from arterial hypertension, 26% diabetes mellitus  16,3% chronic renal failure , 5,2% previous stroke.61% of these patients weared WCD for severe systolic disfunction in ischemic cardiac disease  after recent myocardial infarction, after percutaneous coronary intervention or coronary artery bypass graft , 4% after removal of an infected ICD,  35% after newly diagnosed  cardiomyopathy.The average wearing time of WCD was 22,9±2,6 hours daily. We received these  events: 1 sustained ventricular tachicardia, 2 non sustained ventricular tachicardia,  5 atrial fibrillation with  3 T wave oversensing. One patient received inappropriate shock. Eight death was detected due advanced haeart failure.After 60±42,9 days of average wearing time 48% of patients were scheduled for ICD implantation.Considering sex difference we observed in females a better  baseline  LVEF  ( f 34,6±9,8 vs m 28,6±8,1 p=0,008) and a significant lower ICD implantation rate at the end of WCD use [f 8(31%) vs m 48(53%)]. Conclusions In our experience we may consider that WCD use is effective, safe and with a good adherence in all patients. The WCD allows saving resources preventing inapprpriate ICD implantation in patient with transient SCD risk. Females presented a lower ICD implantation rate