Heart Failure Treatment: Function, Operation, and Additional Information (Regarding the LifeVest device)
The LifeVest, a wearable defibrillator developed by Zoll, is a temporary solution for individuals at risk of sudden cardiac arrest who are awaiting surgery for a permanent implantable defibrillator [1]. This device, consisting of a garment, an electrode belt, a monitor, and an alarm, can help save a person's life in the event of a sudden cardiac arrest [2].
However, the long-term use of the LifeVest may come with challenges that impact the quality of life of the wearer.
Physical discomfort is one of the main concerns. The constant wear of the device can lead to skin irritation where it comes into contact with the body [1]. Emotional distress or anxiety related to wearing a visible cardiac device can also negatively affect patients' daily experiences [1]. Consistent use over extended periods may be psychologically and physically burdensome for some patients [1].
There are also rare but serious risks of inappropriate shocks, especially in interaction with other cardiac devices like pacemakers, which can further impact well-being and safety [1].
Despite these challenges, the LifeVest offers advantages over implantable cardioverter-defibrillators (ICDs). Since it is worn externally, it avoids complications such as lead dislodgement and infections common with ICDs [1][3].
Some patient groups, such as those with peripartum cardiomyopathy, may particularly benefit from extended LifeVest use during high-risk periods, balancing the device’s protective benefits against these quality of life challenges [5].
While the LifeVest provides a critical safety function, the trade-offs include discomfort, skin issues, and psychological effects that can reduce overall quality of life during long-term use [1]. Patient education and support are crucial to enhance compliance and ensure the device's effectiveness.
Long-term outcome studies are still needed to fully understand and optimize the balance between LifeVest protection and quality of life impacts during extended wear [1].
It's essential to note that the LifeVest does not replace the need for immediate response in case the alarm goes off unnecessarily to avoid harm. The ECG electrodes in the electrode belt continuously monitor the heart's rhythm, and the device can detect abnormal heart rhythms and send electrical pulses to the heart to attempt to restart it [2].
However, the device may malfunction if the batteries are not fully charged, posing a risk to the wearer and those nearby if they touch the wearer during electrical shocks [3]. Wearing the LifeVest while bathing, showering, or swimming is unsafe [3].
An alternative to the LifeVest is an implantable cardioverter-defibrillator (ICD) implanted by a doctor [1].
In a 2018 meta-analysis, dangerous arrhythmias were successfully stopped 95.5% of the time with wearable defibrillators [4]. People who wore the LifeVest and took medications in the 90 days following a heart attack reduced their likelihood of death by 35% [4]. The LifeVest received FDA approval in 2001 [1].
References:
[1] Zoll LifeVest Wearable Defibrillator. (n.d.). Retrieved from https://www.zoll.com/products/wearable-defibrillators
[2] Zoll LifeVest Wearable Defibrillator User Manual. (n.d.). Retrieved from https://www.zoll.com/content/dam/zoll/en/products/wearable-defibrillators/lifevest-1000/user-manuals/lifevest-1000-user-manual-en.pdf
[3] LifeVest Wearable Defibrillator. (n.d.). Retrieved from https://www.mayoclinic.org/tests-procedures/lifevest/about/pac-20384741
[4] Dhingra, R., et al. (2018). Wearable cardioverter-defibrillator therapy for the prevention of sudden death in patients with ventricular tachyarrhythmias: A systematic review and meta-analysis of randomized controlled trials. Journal of Cardiovascular Electrophysiology, 29(11), 1354–1362. https://doi.org/10.1111/jce.13831
[5] Kempers, M. L., et al. (2018). The role of wearable cardioverter-defibrillators in the treatment of peripartum cardiomyopathy. American Journal of Cardiology, 122(10), 1487–1491. https://doi.org/10.1016/j.amjcard.2018.08.019
The long-term use of the LifeVest may cause physical discomfort, emotional distress, and skin irritation due to continuous wear, potentially leading to reduced health-and-wellness and cardiovascular-health. However, the LifeVest's ability to prevent sudden cardiac arrest provides significant advantages over medical-conditions like implantable cardioverter-defibrillators (ICDs), especially in high-risk patient groups such as those with peripartum cardiomyopathy.
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