CONGRESS ABSTRACT

Background Nowadays sudden cardiac death (SCD) remains a major cause of death, despite the recent progress in prevention and interventions of cardiac disease . In case of transient risk of SCD, the use of a wearable cardioverter defibrillator (WCD) is reccomende 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 130 patients discharged from ourcardiology department for potentially transient high risk of SCD, weared a WCD from August 2017 to December 2025.The patients were discharged 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 130 patients , with average age 64,9±11,9 years old and baseline average left ventricular ejection fraction (LVEF) 31 ±9,5,79 % were males,72% suffered from arterial hypertension, 25% diabetes mellitus 16,% chronic renal failure ,6% previous stroke., 22% atrial fibrillation(AF) .57% of these patients weared WCD for severe systolic disfunction in ischemic cardiac disease , 3% after removal of an infected ICD, 40% after newly diagnosed cardiomyopathy. 84% patiemts were in therapy with beta blockers, 39% with sacibitril/valsartan and 38% with glifozine.The average wearing time of WCD was 61±42,9 days and 23±2,4 hours daily. We received these events: 2 sustained ventricular tachicardia, 6 non sustained ventricular tachicardia (TV) , 4 atrial fibrillation . One patient received inappropriate shock. At the end of the WCD use,42% of patients proceeded to device implantation.At last follow up 14 death was detected in patients that weared WCD due ti advanced heart failure.Considering sex difference we observed in females a better baseline LVEF( f 34±9vs m 29±8,1 p=0,03) and a significant lower ICD implantation rate at the end of WCD use [f 7(26%) vs m 48(55%)p=0.04] . During wearing time 7 Tv occured in males and 1 in females. Conclusions In our experience we may confirm that WCD use is, effective, safe and with a good adherence in all patients. The WCD allows resources saving not only during therapy titration but alo by enabling arli discharge supportig appropriet decision making regarding ICD implantation .Females presented a lower ICD implantation rate