Use of wearable cardioverter defibrillators (WCDs) for the prevention of sudden cardiac death is considered medically necessary as interim treatment for those who:
meet the criteria for an implantable cardioverter defibrillator (ICD; see indications in evidence review 07.001.050); and
have a temporary contraindication to receiving an ICD, such as as the ICD waiting period or a systemic infection, at the current time; and
have been scheduled for an ICD placement or who had an ICD removed and have been rescheduled for placement of another ICD once the contraindication is treated; and
patients with a permanent implantable cardioverter-defibrillator (ICD) that must be explanted, or those with a delay in implanting a newly indicated ICD (eg, due to systemic infection).
patients with reduced left ventricular (LV) systolic function (LVEF ≤35 percent) who have had a myocardial infarction (MI) within the past 40 days.
patients with reduced LV systolic function (LVEF ≤35 percent) who have undergone coronary revascularization with coronary artery bypass graft (CABG) surgery in the past three months.
patients with newly diagnosed nonischemic cardiomyopathy with severely reduced LV systolic function (LVEF ≤35 percent) that is potentially reversible.
patients with severe heart failure who are awaiting heart transplantation at high risk for lethal arrhythmias.
women with peripartum cardiomyopathy with reduced LV systolic function (LVEF ≤35 percent)
patient with familial or inherited conditions with a high risk of life threatening ventricular tachyarrhythmia such as long QT syndrome or hypertrophic cardiomyopathy
Use of WCDs for the prevention of sudden cardiac death is considered investigational for the following indications when they are the sole indication for a WCD:
Patients in the immediate (ie, <40 days) period following an acute myocardial infarction Patients post coronary artery bypass graft surgery High-risk patients awaiting heart transplant Patients with newly diagnosed nonischemic cardiomyopathy Women with peripartum cardiomyopathy. Use of WCDs is considered investigational for all other indications.
