There is only limited experience using wearable cardioverter-defibrillators (WCD) in juvenile patients. Researchers determined how a WCD was successfully used in adolescents with hypertrophic cardiomyopathy and myocardial bridging. A 15-year-old girl experienced repeated syncope, dyspnea, and vertigo with exercise. They discovered Non-obstructive hypertrophic cardiomyopathy and symptoms of myocardial ischemia during the diagnostic work-up. The patient was scheduled for an implanted cardioverter-defibrillator (ICD) as a precaution.
The patient collapsed during an episode of prolonged ventricular tachycardia (VT) while running one month after the initial presentation and days before the planned ICD placement. They used WCD shocks to put an end to VT. Following the occurrence, a computed tomography scan revealed myocardial bridging of the left anterior descending coronary artery, resulting in a 90% stenosis in systole. Life-threatening arrhythmias did not reoccur following coronary surgery, but the patient needed a heart transplant after two years due to worsening heart failure. The described case emphasized the necessity and application of WCDs in juvenile high-risk patients and the potentially harmful nature of myocardial bridging.
Reference:bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02113-w
