Wearable Cardioverter-Defibrillator in a Patient with Left Ventricular Noncompaction/Hypertrabeculation, Coronary Artery Disease, and Polyneuropathy

A 55-year-old Caucasian male with coronary heart disease was admitted because of dyspnea for 4 weeks. Echocardiography showed a dilated left ventricle with an ejection fraction of 34% and apical left ventricular hypertrabeculation/noncompaction with an apical thrombus. Neurologic examination revealed positional tremor and generally reduced tendon reflexes. During 8 weeks, his condition improved under pharmacotherapy. The patient was skeptical about implantable cardioverter-defibrillator (ICD) and expected further improvement from pharmacotherapy. Thus, he received a wearable cardioverter-defibrillator (WCD). We conclude that a WCD might be useful in noncompaction patients in whom improvement of systolic dysfunction is expected or who are skeptical about ICDs.