<International Circulation>:  Concerning WCD (wearable cardiac defibrillators)， in what situations do you really feel they can be used?  Are they really a temporary solution who cannot get an implantable cardiac defibrillator (ICD)?

   《国际循环》：在您看来，WCD(穿戴式心脏去纤颤器)究竟在何种情况下真正适合使用？您认为，它们是否只是不能接受植入性心脏除颤器（ICD）的患者的权宜之计？
 
    Prof. Thomas Dewland:  I think so.  The use of this type of device long term has been postulated in patients who have a standard indication for an ICD but don’t want one.  That is very problematic since many studies have shown that compliance with these vests is not 100%.  Patients usually where them about 16-20 hours per day， which means there is a lot of time that they are not protected.  The best use of this device is for patients in special circumstances where they don’t meet standard criteria for an ICD or are at heightened risk for an arrhythmia， and usually then only for a short period of time.  A WCD can be used to bridge them through that period of heightened risk or bridge them through until they are at a time point where they can get an ICD.

    Dewland教授：我的确是这样认为的。存在使用ICD的标准指证但是不想接受这类治疗是患者长期使用这类设备的基本条件。这里存在一个很大的问题，因为许多研究表明，患者对这种背心的依从性不是100%。患者通常每天穿16-20个小时，这就意味着有很长一段时间他们没有得到应有的保护。对这种设备的最佳使用条件是，患者处在一个特殊情况下，如他们不符合接受ICD的标准，或者出现心律失常的风险升高，通常他们处在这种情况下的时期较短。WCD可以帮助他们通过这一段高风险时期，或者帮助他们坚持到能够满足ICD治疗条件的时间点。
 
    <International Circulation>: What kind of temporary periods are we talking about?

   《国际循环》：我们所说的这一临时时期究竟是什么样的呢？
 
    Prof. Thomas Dewland:  Usually on the order of months.  There is an ongoing study now using these WCD vests looking at patients immediately after myocardial infarction.  These patients， based on previous trials， should not be treated with an ICD for the first 40 days after infarct.  The question is， will treatment with the WCD provide them with protection from arrhythmic death during that short time?  In addition， some patients awaiting cardiac transplant may benefit from this device.  Some patients who have a recent drug exposure that temporarily prolongs their QT interval puts them at a higher risk and the vest may be indicated in these patients.  

    Dewland教授：通常类似月份。现在有一个正在进行的研究，观察患者心肌梗死后立刻使用了WCD背心的表现。根据以往的试验，这类患者在心肌梗死后头40天不应该接受ICD疗法。问题在于，使用WCD能否在这一短暂时间内保护患者免于死于心律失常。另外，对于一些等待心脏移植的患者来说，也可以从这一设备上获益。还有一些接受了近期药物暴露的患者，临时延长QT间隔增大了他们危险性，这种背心也可以用于这类患者。