Wearable cardioverter defibrillators (WCDs), or LifeVest®, are non-implantable devices that are potentially lifesaving for patients at risk of sudden cardiac death. If a life-threatening irregular heart rhythm is detected, the vest automatically delivers a treatment shock to restore a normal rhythm.
Currently, there is only one FDA-approved WCD in the market: the Zoll LifeVest®. The evidence supports its efficacy with a “>94% survival rate”, making it an ideal solution for patients that don’t qualify for implantable cardioverter-defibrillators (devices placed inside the body to monitor the heart rhythm).
In fact, the survival rate for a WCD is similar to that of implantable devices, making it a more convenient and less invasive option.
Here is a quick look into its pros and cons
| PROS | CONS |
|---|---|
| First ever Wearable Cardioverter Defibrillator | Bulky design |
| FDA Approved | Hard plastic electrodes |
| Non-invasive; no surgery needed. | Complex and bulky setup |
| Removable and washable vest | Hard to sleep in/inability to shower in. |
| Tracks heart health to create a shareable report | May cause skin itchiness or rashes |
| Sends alerts regarding rhythm problems | Low Battery Life (24 Hours) |
| Up to 5 shocks in total | Extensive 16-hour charging time |
| A high survival rate of >94% with minimal risks | Challenging fit for overweight individuals |
You’ve just been diagnosed with a condition that puts you at risk for sudden cardiac death (SCD). That’s no joke. To begin with, it would mean a series of alterations in your lifestyle.
However, it’s the 21st century. If there’s anything we’ve seen, it’s the strides technology has made to turn the impossible into possible; and the healthcare industry is no exception to that.
Over the last decade, there has been significant development of devices that can offer advanced healthcare solutions while prioritizing quality of life, and we have witnessed the same advancement in the management of sudden cardiac death.
If you ask your doctor for a solution that doesn’t mean giving up your entire life but also being protected from sudden cardiac death, you might be pleasantly surprised: it’s known as the Zoll LifeVest®.
The LifeVest® is a wearable cardioverter defibrillator that is self-contained and non-implantable. You wear it exactly like a vest, under your clothing but outside the body.
It is indented to reduce the risk of sudden cardiac arrest or death due to ventricular tachycardia or ventricular fibrillation, both of which are types of abnormal heart rhythm.
In the former’s case, the lower chambers of the heart beat faster than they should, and in the latter, the heart’s beating process isn’t happening in the right order.
How Does the LifeVest® Work?
It is comprised of three main components:
- The Garment: Designed to look like a vest, it is worn directly against the skin. The garment also includes the electrode belt.
- The Electrode Belt: Detects irregular heart rhythms and delivers a treatment shock to jolt the heart to resume regular activity.
- The Monitor: Worn around the waist or with the shoulder strap, it consistently records the heart rate.
A key feature of the LifeVest® is the series of alerts and voice prompts it provides to the user to indicate an irregular heartbeat when the treatment is about to start and so on. If you face an irregular heartbeat, the device will vibrate against your skin, alerting you with a tone.
If you’re conscious and don’t need defibrillation, you’ll press two buttons to signal your response. If you don’t, it assumes that you are unconscious and may be in danger of sudden cardiac arrest.
In such cases where a life-threatening rapid heartbeat is detected, the LifeVest® electrodes release a gel and deliver the shock in about one minute. If your heart doesn’t start beating normally after the first shock, the LifeVest will deliver another one – around 5 shocks in total.
The LifeVest® is to be worn at all times, other than when you shower or bathe. It’s also required to recharge the battery daily (16-hour charging time). There are two batteries, so when one is being charged, you can swap it with another charged one.
The garment is washable and it is recommended that it’s washed once every two days; JUST the garment, not the electrode belt or monitor.
Am I a Good Fit?
The LifeVest® is an ideal solution for patients that don’t qualify for implantable cardioverter-defibrillators, which is the conventional solution for sudden cardiac death.
You might be a good fit for it if:
- You’re waiting for an implantable defibrillator, but surgery needs to be delayed.
- You have a newly diagnosed condition, such as cardiomyopathy. For instance, you just had a heart attack, which has reduced your heart function. In that case, your doctor would want to monitor your heart function to determine whether you need an implantable defibrillator.
- You suffer from severe heart failure and are on the organ transplant waiting list.
- You simply need some more time to understand your condition and weigh the benefits and risks of the implantable cardioverter defibrillator, which is a permanent treatment
How Does the Evidence Hold Up?
The LifeVest® is FDA-approved. Based on a clinical study, it demonstrated a success rate of at least 25% with 90% statistical confidence. There were also results from the bench tests and animal and clinical studies that offered adequate assurance of the safety and effectiveness of the LifeVest.
Since its introduction in the market, there have been numerous studies conducted to determine the success of the LifeVest®. The following are the concluding statements of selected research findings, all of which demonstrate positive results for the LifeVest®:
Nguyen et al. 2018(1)
“WCDs appear to be successful in terms of terminating VT/VF in patients with an elevated risk of SCD and are appropriate for use while long-term risk management strategies are being identified.”
Garcia et al. 2021(2)
“Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients.”
Kutyifa et al. 2018(3)
“One-year follow-up from the WEARIT-II Registry shows an overall good survival in patients prescribed the WCD.”
Spar et al. 2018(4)
“The WCD is safe and effective in treating ventricular arrhythmias that can lead to sudden cardiac death in pediatric patients.”
Ellenbogen et al. 2017(5)
“WCD demonstrated a high efficacy for protecting patients from VT/VF. Clinicians may use the WCD as an ICD (Implantable Cardioverter Defibrillator) alternative when reimplantation is medically delayed.”
Epstein et al. 2013(6)
“The WCD may benefit individual patients selected for high risk of SCA early post-MI.”
Weighing the Pros and Cons
Well, the first and the most prominent pro has to be that it could potentially save your life. A study conducted in 2017 showed that WCDs demonstrated high efficacy in protecting patients from ventricular tachycardia or ventricular fibrillation.
There are consistent technological advancements being made to the LifeVest®, which has made it possible to even transmit information about your heart rhythm to your doctor as a means to guide your treatment.
One potential downside is the discomfort of having to wear the vest. Some people have complained about skin issues such as itching. It can also be difficult to sleep in.
The data regarding device problems is minimal with a few complaints regarding battery life, inappropriate shocks, power-up/charging errors, circuit failure, etc. Again, the data is extremely limited.
However, when you compare these to being able to increase the odds of saving your life, the cons don’t really stand out much.
Frequently Asked Questions
How serious is wearing a LifeVest?
No matter where you are or the time of day, the LifeVest WCD can provide sudden cardiac death (SCD) protection when worn as directed. LifeVest can protect you even when you are alone. It is therefore critical that you wear the LifeVest WCD at all times—including while you sleep.
How long do you wear a life vest with defibrillator for?
For a period of 90 days
Typically, you will wear a LifeVest® for 90 days before your doctor performs an ultrasound to determine whether you require a defibrillator. You should constantly wear the defibrillator vest, however you can take it off for showers.
Is a LifeVest a wearable defibrillator?
Patients at risk of sudden cardiac death (SCD) wear the LifeVest® wearable cardioverter defibrillator (WCD). A defibrillator is a device that uses an electrical shock to the heart to control dangerously fast heart rhythms.
How long can you survive with a life vest?
People have worn a LifeVest for up to seven years. Many people, however, only wear them for a few weeks or months.
How do you sleep with a defibrillator?
Sleep on the other side if you have an implanted defibrillator. Because the majority of defibrillators are implanted on the left side, sleeping on the right side may be more pleasant.
To Sum it Up
Most of the research and studies only reinforce the efficacy and safety of LifeVest. Another relieving thing to note about WCDs is that they don’t involve surgery.
Given that it doesn’t have a sense of permanence attached to it, it is a more digestible solution for patients. It allows people to resume normal, daily activities without having to constantly worry about whether they’re at risk of sudden cardiac death.
However, as with most medical treatments, it is important that wearable cardioverter defibrillators are prescribed appropriately. If your doctor suggests that you go for the LifeVest, it is crucial that you are equipped with the know-how of how the WCD works, as well as scheduling regular follow-ups to ensure that it is doing its job.
There is currently only one FDA-approved wearable cardioverter defibrillator available, which is the Zoll LifeVest®. Therefore, you don’t have to feel overwhelmed about choosing from a sea of options. There is only one that you can go for, which by default, makes it the best out there.
Selected References
- Nguyen, E, Weeda, ER, Kohn, CG, D’Souza, BA, Russo, AM, Noreika, S, and Coleman, CI. Wearable Cardioverter-defibrillators for the Prevention of Sudden Cardiac Death: A Meta-analysis. Journal of Innovations in Cardiac Rhythm Management. 2018.
- Garcia, R, Combes, N, Defaye, P, Narayanan, K, Guedon-Moreau, L, Boveda, S, Blangy, H, Bouet, J, et al. Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: The WEARIT-France cohort study. Europace. 2021;23(1):73-81.
- Kutyifa, V, Moss, AJ, Klein, HU, McNitt, S, Zareba, W, and Goldenberg, I. One-year follow-up of the prospective registry of patients using the wearable defibrillator (WEARIT-II Registry). Pacing Clin Electrophysiol. 2018;41(10):1307-1313. Spar, DS, Bianco, NR, Knilans, TK, Czosek, RJ, and Anderson, JB. The US Experience of the Wearable Cardioverter-Defibrillator in Pediatric Patients. Circ Arrhythm Electrophysiol. 2018;11(7):e006163.
- Ellenbogen, KA, Koneru, JN, Sharma, PS, Deshpande, S, Wan, C, and Szymkiewicz, SJ. Benefit of the Wearable Cardioverter-Defibrillator in Protecting Patients After Implantable-Cardioverter Defibrillator Explant: Results From the National Registry. JACC Clin Electrophysiol. 2017;3(3):243-250.
- Epstein, AE, Abraham, WT, Bianco, NR, Kern, KB, Mirro, M, Rao, SV, Rhee, EK, Solomon, SD, et al. Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post-myocardial infarction. J Am Coll Cardiol. 2013;62(21):2000-2007.
- Olgin, JE, Pletcher, MJ, Vittinghoff, E, Wranicz, J, Malik, R, Morin, DP, Zweibel, S, Buxton, AE, et al. Wearable Cardioverter-Defibrillator after Myocardial Infarction. N Engl J Med. 2018;379(13):1205-1215.
- Zishiri, ET, Williams, S, Cronin, EM, Blackstone, EH, Ellis, SG, Roselli, EE, Smedira, NG, Gillinov, AM, et al. Early risk of mortality after coronary artery revascularization in patients with left ventricular dysfunction and potential role of the wearable cardioverter defibrillator. Circ Arrhythm Electrophysiol. 2013;6(1):117-128. Nihms440306.
- Huber, NL, Burch, AE, Bianco, NR, Spar, DS, and Sears, SF. Children with wearable cardioverter defibrillators: Examining activity levels via accelerometer. Progress in Pediatric Cardiology. 2019;55 Article Number: 101137.
- Burch, AE, D’Souza, B, Gimbel, JR, Rohrer, U, Masuda, T, Sears, S, and Scherr, D. Physical activity is reduced prior to ventricular arrhythmias in patients with a wearable cardioverter defibrillator. Clinical Cardiology. 2020;43(1):60-65.
- Kutyifa, V, Moss, A H, Biton, Y, McNitt, S, MacKecknie, B, Zareba, W, and Goldenberg, I. Use of the wearable cardioverter defibrillator in high-risk cardiac patients: data from the Prospective Registry of Patients Using the Wearable Cardioverter Defibrillator (WEARIT-II Registry). Circulation. 2015;132(17):1613-1619.
