J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 12, Number 2, February 2021, pages 49-53

Phantom Shocks Associated With a Wearable Cardioverter Defibrillator

**Table 1.** Indications for ICD Placement for Primary and Secondary Prevention of SCD [4]
^aLVEF ≤ 35%, on maximal GDMT for at least 3 months and has intraventricular conduction delay of more than 120 ms. ICD: implantable cardioverter defibrillator; SCD: sudden cardiac death; MI: myocardial infarction; LVEF: left ventricular ejection fraction; NICM: non-ischemic cardiomyopathy; GDMT: goal-directed medical therapy; CRT: cardiac resynchronization therapy; BVICD: biventricular implantable cardioverter defibrillator; VT: ventricular tachycardia; VF: ventricular fibrillation.
Primary prevention of SCD
MI within the past 40 days and LVEF ≤ 35%
Patients with NICM with LVEF ≤ 35% after 3 months of optimized GDMT
HF patients who are candidates for CRT with BVICD^a
Patients with congenital long QT syndrome with recurrent symptoms despite medical therapy
High-risk patients with hypertrophic cardiomyopathy
High-risk patients with Brugada syndrome, polymorphic VT and other channelopathies
Secondary prevention of SCD
Prior episode of survived VF/VT or sustained hemodynamically unstable VT without an identifiable reversible cause
Patients with episodes of spontaneously sustained VT in the presence of heart disease

Table 1. Indications for ICD Placement for Primary and Secondary Prevention of SCD [4]

^aLVEF ≤ 35%, on maximal GDMT for at least 3 months and has intraventricular conduction delay of more than 120 ms. ICD: implantable cardioverter defibrillator; SCD: sudden cardiac death; MI: myocardial infarction; LVEF: left ventricular ejection fraction; NICM: non-ischemic cardiomyopathy; GDMT: goal-directed medical therapy; CRT: cardiac resynchronization therapy; BVICD: biventricular implantable cardioverter defibrillator; VT: ventricular tachycardia; VF: ventricular fibrillation.

Primary prevention of SCD

MI within the past 40 days and LVEF ≤ 35%

Patients with NICM with LVEF ≤ 35% after 3 months of optimized GDMT

HF patients who are candidates for CRT with BVICD^a

Patients with congenital long QT syndrome with recurrent symptoms despite medical therapy

High-risk patients with hypertrophic cardiomyopathy

High-risk patients with Brugada syndrome, polymorphic VT and other channelopathies

Secondary prevention of SCD

Prior episode of survived VF/VT or sustained hemodynamically unstable VT without an identifiable reversible cause

Patients with episodes of spontaneously sustained VT in the presence of heart disease

**Table 2.** Indications for WCD Placement [5, 6]
WCD: wearable cardioverter defibrillator; NICM: non-ischemic cardiomyopathy; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; GDMT: goal-directed medical therapy; ICM: ischemic cardiomyopathy; ICD: implantable cardioverter defibrillator; MI: myocardial infarction; CABG: coronary artery bypass graft surgery; SCD: sudden cardiac death; MC: myocarditis; PPCM: peripartum cardiomyopathy; SIC: stress-induced cardiomyopathy; HFrEF: heart failure with reduced ejection fraction.
Patient populations
Patients with NICM and LVEF ≤ 35%, NYHA class II-III less than 3 months of GDMT
Patients with ICM and LVEF ≤ 35%, NYHA class II-III who cannot undergo ICD placement, within 40 days of MI or 90 days of a CABG procedure
Patients awaiting ICD reimplantation after device infection or dislodgement
Patients who are not good candidates for ICD or are not good surgical candidates
Patients who prefer less invasive means for SCD prophylaxis
Patients with a possibly reversible cause of reduced LVEF (MC, PPCM, SIC)
Patients with terminal HFrEF awaiting to undergo cardiac transplant in near future

Table 2. Indications for WCD Placement [5, 6]

WCD: wearable cardioverter defibrillator; NICM: non-ischemic cardiomyopathy; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; GDMT: goal-directed medical therapy; ICM: ischemic cardiomyopathy; ICD: implantable cardioverter defibrillator; MI: myocardial infarction; CABG: coronary artery bypass graft surgery; SCD: sudden cardiac death; MC: myocarditis; PPCM: peripartum cardiomyopathy; SIC: stress-induced cardiomyopathy; HFrEF: heart failure with reduced ejection fraction.

Patient populations

Patients with NICM and LVEF ≤ 35%, NYHA class II-III less than 3 months of GDMT

Patients with ICM and LVEF ≤ 35%, NYHA class II-III who cannot undergo ICD placement, within 40 days of MI or 90 days of a CABG procedure

Patients awaiting ICD reimplantation after device infection or dislodgement

Patients who are not good candidates for ICD or are not good surgical candidates

Patients who prefer less invasive means for SCD prophylaxis

Patients with a possibly reversible cause of reduced LVEF (MC, PPCM, SIC)

Patients with terminal HFrEF awaiting to undergo cardiac transplant in near future